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Interventional Treatment Options for Post-mastectomy Pain.

Aarthi Murugappan1, Ashish Khanna2

  • 1Department of Physical Medicine and Rehabilitation Medicine, Emory University School of Medicine, 1441 E Clifton Rd NE, Atlanta, GA, 30322, USA.

Current Oncology Reports
|August 30, 2023
PubMed
Summary

Interventional pain management offers new options for breast cancer patients suffering from post-mastectomy pain syndrome. Procedures like nerve blocks and botulinum toxin injections can supplement traditional therapies for improved pain relief.

Keywords:
Breast cancerBreast reconstructionChest wall painInterventional oncologyNerve blocksPost-mastectomy pain

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Area of Science:

  • Oncology
  • Pain Medicine
  • Surgical Oncology

Background:

  • Breast cancer is the most common global cancer diagnosis.
  • Patients experience significant pain and morbidity post-treatment, including radiation fibrosis, muscle spasms, and neuropathy.
  • Post-mastectomy pain syndrome affects 25-60% of individuals after breast surgery.

Purpose of the Study:

  • To review interventional pain management options for breast cancer patients.
  • To supplement conservative measures like physical therapy and medication.
  • To address pain and functional limitations following breast cancer treatment and reconstruction.

Main Methods:

  • Review of current interventional pain management procedures.
  • Focus on novel techniques supplementing conservative care.
  • Identification of commonly performed interventional procedures.

Main Results:

  • New interventional procedures effectively treat chest wall pain, neuropathic pain, and spasticity.
  • Commonly performed procedures include botulinum toxin injections and various nerve blocks (serratus anterior plane, intercostobrachial, thoracic paravertebral, pectoralis, erector spinae).
  • Combined interventional and conservative approaches can manage post-mastectomy pain syndrome.

Conclusions:

  • Interventional pain management provides valuable options for breast cancer patients.
  • A multimodal approach combining interventional procedures with physical therapy and pharmacologic interventions is recommended.
  • These strategies can significantly improve the quality of life for millions of breast cancer survivors.