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Breast Pain After Surgery

Short term pain after surgery for breast cancer is not a major issue for many patients.  Beyond a soreness that lasts 2 to 3 days and some tightness under the arm after a mastectomy, there is often very little physical discomfort at all. This is due in part to the fact that muscles in the area affected by surgery are not used in many day-to-day tasks, and are therefore less prone to irritation by body movement.

In the long term, though, some patients complain of breast pain (known medically as mastalgia) that they associate with their surgery even years after the surgery occurred.

Statistically, the incidence of long term pain in women who undergo mastectomy without reconstruction is similar to that experienced by those who have a mastectomy and reconstruction without implants. However, the incidence of long term pain is significantly higher for women who have a mastectomy followed by reconstruction with implants.

Another rule of thumb is that patients who experience pain in their breast or breasts before surgery are likely to continue having pain afterwards as well.  This is especially true in women who experience what is known as phantom breast pain, sometimes known by the acronym PBP.

"...breast pain is very seldom an indicator of cancer; a fact that should offer some comfort to women living with the fear of recurrence."
Phantom breast pain is similar to the phenomenon of phantom limb pain experienced by persons who lose an arm or leg. Even when an arm or leg is gone, some amputees feel pain that their brain interprets as coming from the missing limb.

In patients who undergo mastectomy, the “limb” is their breast. This phenomenon, though not uncommon, is poorly understood. The most likely explanation is that when nerves are severed, the brain rewires the region that previously processed sensations traveling from the now damaged pathway. Adding to the confusion is the tendency of injured nerves to fire randomly in the area where the damage has occurred.

Patients who experience significant breast pain, including phantom breast pain, should report it to their physician.   The physician, in turn, will likely recommend medication, massage, exercise, a well fitted bra, or some combination of these solutions.

Finally, if there is any good news related to mastalgia, it is that it breast pain is very seldom an indicator of cancer; a fact that should offer some comfort to women living with the fear of recurrence.