Neuropathic postoperative chronic pain syndrome following breast cancer surgery

Epidemiological studies report that one in eight women will develop breast cancer and it is estimated that almost 50 per cent of women suffer from chronic pain following breast cancer surgery. Despite this awareness, post surgical pain still remains poorly recognized and underestimated as a cause for morbidity. Diverse mechanisms can be responsible for generating pain, even after the same type of procedure.Most studies have shown a distinct correlation between the extent of armpit lymph node dissection and the subsequent development of chronic nerve pain syndromes involving the upper arm. Neuropathic syndromes are the result of the response of the nervous system to operative injury and healing process. While neuropathic pain is considered the primary cause of persistent postoperative pain, now there is increasing discussion that in some patients, ongoing nociception might be playing a role in this condition. Along with the advances in breast cancer management, that prolong survival, there will be an increased necessity of controlling post-operative late complications, like chronic pain, and their harsh influence on quality of life. Newer techniques, like scrambler therapy or transcutaneous electrical nerve stimulation, have promising results and will certainly prove to be effective for some cases.