Acute and persistent post-operative pain following mastectomy: a descriptive study in a tertiary hospital cohort

N Z Med J. 2024 Aug 23;137(1601):36-47. doi: 10.26635/6965.6524.

Abstract

Aims: Post mastectomy pain syndrome (PMPS) can have significant negative effects on patients' quality of life after mastectomy. The estimated prevalence of PMPS varies widely and there is little data from a New Zealand population. This limits clinicians' ability to meaningfully describe and discuss pain-related complications of mastectomy peri-operatively.

Method: We designed a single-centre, retrospective study to describe acute post-operative analgesic requirements after mastectomy, to describe the prevalence of PMPS at least 1 year after surgery, and to identify associated risk factors for this complication.

Results: One hundred and thirty mastectomy patients met inclusion criteria and 59 were willing and able to participate in 12-month follow-up. Acute post-operative pain was generally well managed with modest doses of oral analgesics. Sixty-six percent (n=39) of women reported some form of persistent pain symptoms post-mastectomy; this was associated with younger age, axillary surgery and chemotherapy. Only 5% of patients (n=3) met consensus criteria for PMPS, which limited identification of risk factors for this more severe complication.

Conclusion: Despite PMPS occurring infrequently, post-operative pain of a less severe nature after mastectomy occurs commonly. Clinicians should remain vigilant to possible risk factors for this post-operative complication and counsel patients appropriately.

MeSH terms

  • Acute Pain / drug therapy
  • Acute Pain / epidemiology
  • Acute Pain / etiology
  • Adult
  • Aged
  • Analgesics / therapeutic use
  • Breast Neoplasms* / surgery
  • Chronic Pain / drug therapy
  • Chronic Pain / epidemiology
  • Chronic Pain / etiology
  • Female
  • Humans
  • Mastectomy* / adverse effects
  • Middle Aged
  • New Zealand / epidemiology
  • Pain Measurement
  • Pain, Postoperative* / drug therapy
  • Pain, Postoperative* / epidemiology
  • Pain, Postoperative* / etiology
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Tertiary Care Centers*

Substances

  • Analgesics