Postmastectomy Pain Syndrome Treated with Neurectomy and Dermal Sensory Peripheral Nerve Interfaces: Improvements in...

Neuropathic postmastectomy pain syndrome (nPMPS) is a common debilitating condition following mastectomy and other breast surgery for which surgical treatment algorithms have been incompletely investigated. This study evaluated whether neurectomy with dermal sensory peripheral nerve interface (DSPNI) can effectively reduce pain and comorbidities resulting from nPMPS.

A single-center prospective cohort study was performed to assess patient-reported outcomes and clinical data logs collected from patients undergoing neurectomy with DSPNI for chronic breast pain between July of 2019 and April of 2023. Women aged 18 years and older who previously underwent prophylactic or therapeutic breast cancer-related lumpectomy or mastectomy and who had a neuropathy component to their pain were recruited for this study as a consecutive sample. Patient-reported outcomes and clinical data logs were prospectively recorded preoperatively and postoperatively.

Twenty patients undergoing neurectomy with DSPNI for nPMPS were evaluated. Average numeric pain rating scale pain scores decreased from 6.9 to 0.6 at 9 months after neurectomy, whereas Short-Form McGill Pain Questionnaire-2 scores decreased from 4.4 to 2.5. Patient-Reported Outcomes Measurement Information System subscores assessing pain intensity, pain interference, and neuropathic pain decreased from 7.9 to 4.9, 16.2 to 11.0, and 8.6 to 6.0, respectively. Pain Catastrophizing Scale scores decreased from 27.5 to 14.1. Opioid use reduced from 1.3 medications preoperatively to 0.4 postoperatively, whereas daily oral morphine equivalents reduced from 43.3 to 12.0. Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 item scores decreased from 10.3 to 7.2 and 7.3 to 4.3, respectively.

This prospective cohort study evaluating the use of neurectomy with DSPNI for chronic nPMPS demonstrates its safety and efficacy in significantly reducing pain, anxiety, depression, and opioid use.