Post mastectomy pain syndrome (PMPS) is persistent nerve pain that people may experience after having a mastectomy or some types of breast-conserving surgery.
PMPS is a neuropathic condition, which means it affects the nerves. People with PMPS may experience long-term pain, tingling, or numbness in the arm, underarm, or chest area after having a mastectomy, or breast-conserving surgery.
This article looks at causes, symptoms, and treatment options for PMPS. It also examines how common it is and a person’s outlook.
Symptoms of PMPS may include:
- pain or tingling in the chest wall, underarm, or arm
- shoulder pain
- pain in the surgical scar
- shooting or prickling pain
- intense itching
According to a 2020 study, PMPS pain can begin anywhere between 2 weeks to 3 months after surgery. The initial symptoms may be intermittent.
How long does it last?
A 2022 article defines PMPS as chronic pain in the chest and arm area that lasts for
Without treatment, some people may experience pain which continues for
PMPS can occur after surgery for breast cancer. This includes a mastectomy and other types breast surgery, such as a lumpectomy.
According to a 2020 study, nerve damage during surgery may cause PMPS. Certain factors may also increase the risk of PMPS, such as:
- a previous history of chronic pain
- postoperative pain, and intensity of the pain
- having a total mastectomy
- being 35 years of age or younger
- tumor grade
- high body max index
- if people have had additional treatment of chemotherapy or radiotherapy
- having axillary lymph node dissection
- preoperative anxiety, or other psychological conditions
According to the American Cancer Society (ACS), around
Axillary lymph node dissection may increase the risk of PMPS, but surgeons use this treatment less often. This means PMPS is not as common as it used to be.
A 2020 study looked at the prevalence of PMPS in people who received surgical treatment for early-stage breast cancer, and who had received a diagnosis between 2012–2017. Out of 1,983 participants who completed a questionnaire survey, 28.2% of those had PMPS.
Treatment for PMPS focuses on relieving pain, as well as any side effects of PMPS such as mental health issues.
Physical therapy may help preserve movement, strength, and function of the upper body.
People may be able to begin physical therapy as early as the day after surgery, and do strengthening exercises for
Pain relief medications
A doctor may prescribe medications to help relieve symptoms, such as:
- selective serotonin-norepinephrine reuptake inhibitors (SNRIs)
- selective serotonin reuptake inhibitors (SSRIs)
- tricyclic antidepressants
Prescription medications for PMPS may cause side effects. It is important to discuss possible risks with a healthcare professional, particularly with the use of opioids.
Psychological therapies may help people cope with PMPS, as well as any co-occurring anxiety or depression.
Therapies may include relaxation techniques such as hypnosis, education, and cognitive behavioral therapies.
Autologous fat graft
An autologous fat graft for PMPS transfers fat from one area of the body to the area of pain.
Research suggests that autologous fat grafting may show promise as a treatment for PMPS, but a small-scale 2022 study did not find any significant difference between fat grafting and a placebo in treating PMPS.
Depending on the severity of symptoms, people may be able to manage PMPS with OTC pain relief medications, such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs).
Other OTC treatments may include:
- Topical capsaicin: A topical capsaicin cream or patches containing 8% capsaicin may provide some relief. People may apply 1–4 patches to the area of pain for 30–60 minutes every 3 months.
- Lidocaine patches: People may use 1–3 patches daily on the area of pain for up to 12 hours.
People may also want to discuss alternative therapies with a healthcare professional. These may include:
- therapeutic massage
There is currently little evidence on the effect of alternative therapies on PMPS.
PMPS is a
Physical therapy, particularly if started shortly after surgery,
Psychological treatments may help people to manage any anxiety or depression which may accompany a chronic pain condition.
A combination of treatments may provide the best outlook for PMPS.
PMPS is chronic nerve pain that occurs after a mastectomy, or other breast-conserving surgery.
People with PMPS have consistent pain, lasting for more than
Treatment for PMPS may help people to manage the condition and relieve symptoms. Treatment may include a combination of methods, including pain relief medication, physical therapy, and psychological therapies.