Prevention of Post-Mastectomy Pain Syndrome: A Review of Recent Literature on Perioperative Interventions

Curr Oncol Rep. 2024 Aug;26(8):865-879. doi: 10.1007/s11912-024-01553-2. Epub 2024 May 30.

Abstract

Purpose of review: Up to 60% of breast cancer patients continue to experience pain three months or more after surgery, with 15 to 25% reporting moderate to severe pain. Post-mastectomy pain syndrome (PMPS) places a high burden on patients. We reviewed recent studies on perioperative interventions to prevent PMPS incidence and severity.

Recent findings: Recent studies on pharmacologic and regional anesthetic interventions were reviewed. Only nine of the twenty-three studies included reported a significant improvement in PMPS incidence and/or severity, sometimes with mixed results for similar interventions. Evidence for prevention of PMPS is mixed. Further investigation of impact of variations in dosing is warranted. In addition, promising newer interventions for prevention of PMPS such as cryoneurolysis of intercostal nerves and stellate ganglion block need confirmatory studies.

Keywords: Breast cancer; Chronic Postsurgical pain; Post-mastectomy pain Syndrome.

Publication types

  • Review

MeSH terms

  • Breast Neoplasms* / surgery
  • Female
  • Humans
  • Intercostal Nerves
  • Mastectomy* / adverse effects
  • Nerve Block / methods
  • Pain, Postoperative* / etiology
  • Pain, Postoperative* / prevention & control
  • Perioperative Care / methods
  • Syndrome