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Pain After Breast Cancer Therapy/Treatment, Causes and Treatment - Post Breast Therapy Pain Syndrome -



Post Breast Cancer Therapy Pain Syndrome (PBTPS):-
                                                                     It is defined as typical pain and associated symptoms (oedema, numbness, dysesthesia etc) located in the chest wall, arms, axilla, shoulder and persists beyond the period of three months. It affects 10 to 30 % of women who have undergone breast surgery. (Breast Cancer)


Causes:-
               Following are the causes of PBTPS
1. Injury to the nerves during surgery
2. Radiation and Chemotherapy further aggravate the injury

It is believed that PBTPS results from injury to nerves during surgery and  Radiation and chemotherapy further aggravate the injury. Because of multi-variant causes, PBTPS encompasses many symptoms which can range from mild to severe. Chest and upper arm pain, numbness, oedema, continuous aching and pain associated with hypersensitivity to pain. The symptoms continue beyond 3 months with same or with increased severity.

The common cause of the onset of symptoms is an injury to nerves, especially to the intercostobrachial nerve, nerves of brachial plexus, long thoracic nerve, thoracodorsal may also be involved.

Younger Women are More At Risk:-

Studies showed that 65 % of women of age between 26 - 49 years develop PBTPS while 26 % of women of age above 70 age develop PBTPS.  An improper surgical technique is the most common cause and the nature of breast cancer in pre-menopausal women is different from that of post menopausal women.


Treatment:-

1. NSAIDs ( ibuprofen, naproxen  and other anti-inflammatory drugs.)
2. Low Dose anti-depression ( SSRIs )
3. Topical counter irritants ( capsacian, and mentholated creams )
4. Local anaesthetics
5. Corticosteroids
6. Other options include;
 a) Thoracic sympathectomy.
 b) Intermittent injection of corticosteroids or anaesthetics in the epidural space. c) Implantable spinal cord stimulators
 d) Regional neurolytic agents
 e) Acupuncture is also helpful.

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