Article Commentary: Pain after Mastectomy and Breast Reconstruction

Abstract

Breast cancer is a potentially deadly disease affecting one in eight women. With the trend toward minimally invasive therapies for breast cancer, such as breast conserving therapies, sentinel node biopsies, and early treatments of radiation and chemotherapy, life expectancy after breast cancer has increased. However, pain after breast cancer surgery is a major problem and women undergoing mastectomy and breast reconstruction experience postoperative pain syndromes in approximately one-half of all cases. Patients post mastectomy and breast reconstruction can suffer from acute nociceptive pain and chronic neuropathic pain syndromes. Several preventative measures to control acute post operative pain and chronic pain states such as post mastectomy pain and phantom pain have been tried. This review focuses on the recent research done to control acute and chronic pain in patients receiving minimally invasive therapies for breast cancer, such as breast conserving therapies of mastectomies and breast reconstruction, sentinel node biopsies, and early treatments of radiation and chemotherapy.

My changed body: breast cancer, body image, distress and self‐compassion

“…These treatments alone, and in combination, produce a number of different side effects. With regard to body image‐specific outcomes, breast surgery involving partial or complete loss of one or both breasts may result in poorly aligned breasts and breast asymmetry, extensive scarring and alteration to breast and/or nipple sensation, need for a breast prosthesis, possible changes to limb mobility and lymphoedema . Chemotherapy presents challenges including hair loss, weight fluctuation, skin and fingernail discolouration and hot flashes related to early‐onset menopause .…”

Opioid‐free anesthesia for patients undergoing mastectomy: A matched comparison

“…10 Mastectomy, especially with reconstruction or axillary dissection, is associated with significant pain and postoperative nausea and vomiting (PONV). 11 This pain has traditionally required opioid-based analgesia for adequate control, with potential to worsen the PONV that approximately half of patients undergoing conventional anesthesia (CA) experience. 12 As a result, the American Pain Society and the American Society of Anesthesiologists recommend multimodal pain control to minimize opioid use.…”

A preliminary study on the pectoralis block II as a part of multimodal analgesia for intra and postoperative pain management in modified radical mastectomy

“…In mastectomy surgery, the dermatome region starts from T2-T5, so by performing pecs block II we expected that we can provide analgesia in the surgery field. 8 This study used 0.25% bupivacaine as a local anesthetic agent with a total volume of 30 mL. Bupivacaine is a long-acting local anesthetic of the amide group.…”