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Neuropathic Pain Prevalence After Axillary Procedures in Breast Cancer: A Systematic Review and Meta-analysis
Jonne Spil1, Lucas G de Groot1, Esmee Kwee1
1Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Clinical Breast Cancer
|August 10, 2026
Summary
Neuropathic pain affects about 22.6% of breast cancer patients after axillary surgery. Rates are higher following axillary lymph node dissection (ALND) compared to sentinel lymph node biopsy (SLNB).
Area of Science:
- Oncology
- Pain Medicine
- Surgical Oncology
Background:
- Improved breast cancer survival necessitates managing long-term patient morbidity.
- Chronic pain, particularly neuropathic pain, is a significant issue post-breast cancer surgery, affecting a substantial proportion of patients.
- A knowledge gap exists regarding the precise prevalence of neuropathic pain specifically after axillary procedures in breast cancer survivors.
Purpose of the Study:
- To systematically review and meta-analyze the prevalence of neuropathic pain following axillary lymph node dissection (ALND) and sentinel lymph node biopsy (SLNB) in breast cancer patients.
- To quantify the pooled prevalence of neuropathic pain after these common surgical interventions.
- To compare the prevalence of neuropathic pain between ALND and SLNB procedures.
Main Methods:
- A systematic review and meta-analysis of studies reporting neuropathic pain prevalence after axillary procedures in breast cancer patients.
- Searches were conducted in Embase, Medline, and Web of Science databases up to February 2025.
- Data from 14 studies, including 2725 patients, were meta-analyzed to determine pooled prevalences.
Main Results:
- The overall pooled prevalence of neuropathic pain after axillary procedures was estimated at 22.6% (95% CI, 15.5-30.6).
- For axillary lymph node dissection (ALND), the pooled prevalence was 26.9% (95% CI, 17.1-37.9) based on 10 studies (1253 patients).
- For sentinel lymph node biopsy (SLNB), the pooled prevalence was 18.8% (95% CI, 10.5-28.5) based on 5 studies (860 patients).
Conclusions:
- Neuropathic pain is a common long-term morbidity following breast cancer axillary surgery, affecting approximately one in five patients.
- The prevalence of neuropathic pain is higher after axillary lymph node dissection (ALND) compared to sentinel lymph node biopsy (SLNB).
- These findings highlight the need for effective pain management strategies in breast cancer survivors undergoing axillary procedures.