Interventional Treatment Options for Post-mastectomy Pain

Curr Oncol Rep. 2023 Oct;25(10):1175-1179. doi: 10.1007/s11912-023-01435-z. Epub 2023 Aug 30.

Abstract

Purpose of review: Breast cancer is currently the most prevalent cancer diagnosed globally, and there is a significant gap in the availability of effective first-line treatment options. In addition to a cancer diagnosis, breast cancer patients face additional pain and morbidity after treatment. Radiation fibrosis, muscle spasms, muscle pain, neuropathy, and limited shoulder function are all potential side effects of breast cancer treatment and breast reconstruction. Post-mastectomy pain syndrome affects 25-60% of people after breast surgery. The current review moves forward to explain interventional pain management options that can be used to supplement conservative measures (physical therapy, medication, topical ointments) to help these patients.

Recent findings: There are many new interventional procedures to treat chest wall pain, neuropathic pain, and spasticity after breast surgery. Currently, the most commonly performed procedures are botulinum toxin injections, serratus anterior plane blocks, intercostobrachial nerve blocks, thoracic paravertebral nerve blocks, pectoralis nerve blocks, and erector spinae nerve blocks. Utilizing one of these interventional procedures, along with physical therapy and pharmacologic interventions, can help manage post-mastectomy pain syndrome in the millions of breast cancer patients diagnosed and treated every year.

Keywords: Breast cancer; Breast reconstruction; Chest wall pain; Interventional oncology; Nerve blocks; Post-mastectomy pain.

Publication types

  • Review

MeSH terms

  • Breast Neoplasms* / etiology
  • Breast Neoplasms* / surgery
  • Chronic Pain* / etiology
  • Female
  • Humans
  • Mastectomy / adverse effects
  • Nerve Block* / methods
  • Pain Management / methods
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / therapy
  • Ultrasonography, Interventional / methods