It’s common to have pain associated with cancer before you have a mastectomy. But not many people realize that you may also experience pain after having surgery. The surgery itself comes with pain, but there is also the possibility of nerve damage and other issues that cause post-mastectomy pain syndrome, or PMPS.

What is PMPS?

PMPS is defined as chronic pain that lasts at least three months after surgery for breast cancer. This nerve pain can show in a number of ways and may not even start until up to six months after surgery. Usually, PMPS pain is in the underside of the arms or the upper chest, and it can cause shooting or burning pains.

Unfortunately, PMPS affects as many as 20–40 percent of women who have had a mastectomy. Post-mastectomy pain syndrome may resolve itself after several months, but for up to half of women suffering from PMPS, it never goes away. Not all doctors and surgeons know about or understand PMPS. As such, it’s possible to not get the information you need about this syndrome before your surgery.

What causes PMPS?

There are several possible causes for PMPS, though no one has positively identified exactly what leads to it. The most common theory is that the mastectomy or even a lumpectomy causes damage to the intercostobrachial nerve. This nerve goes from the outside edge of the breast to the underside of the arm, which is where PMPS generally manifests. The formation of scar tissue around the nerves in this area can also cause PMPS.

What increases risk of PMPS?

While there is no way to definitively say who will or will not get PMPS, there are some risk factors that have been found. If you have chemotherapy or radiation treatment after your surgery, this can significantly increase the risk. In addition, the larger the tumor, the likelier you are to get PMPS. Those who are younger are also at higher risk. Surgeries with a higher risk of nerve damage, such as lumps near the underarm, come with a higher risk of the syndrome.

What is the best treatment for PMPS?

Initial treatment for post-mastectomy pain syndrome generally starts with the regular use of ibuprofen and other nonsteroidal anti-inflammatory drugs. Steroid injections or local anesthetic can be helpful for those with pain that is centered around the scar. Topical anesthetics can also be used to help alleviate pain caused by to PMPS. In severe cases, a nerve block may be used. Some people find relief with nondrug treatments, such as reflexology, massage therapy, and acupuncture. Counseling is beneficial for those dealing with PMPS, as it helps with the psychological aspects of the syndrome.

Dealing with cancer and the treatments for it are difficult. No one expects to have chronic pain after having a mastectomy, even though studies show that a large number of women deal with this pain syndrome. If you’re dealing with PMPS, make sure to consult your doctor for the best course of action.

What is your experience with PMPS? 

Tell us about your pain journey in the comments.

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