Breast cancer

Updated 15 November 2013

Persistent pain after mastectomy common

A study suggests that psychological factors may be to blame for the persistent pain many women feel after a mastectomy.


Although breast cancer treatments have dramatically improved outcomes for women with the disease, ongoing pain continues to trouble many survivors long after they undergo a mastectomy, a new study finds.

In conducting the study, researchers examined 611 women who had a partial or total mastectomy to determine which factors contributed to their pain following the surgery. Those factors included tumour size, stress or demographics. The women had also received chemotherapy and radiation with or without hormone therapy.

One-third of the women reported persistent pain in their breast, underarm, side or arm that had not improved in the three years following their surgery.

Anxiety and depression

Researchers Dr. Inna Belfer, an associate professor of anesthesiology at the University of Pittsburgh, and her colleagues found no evidence that the type of mastectomy a woman had, the size of her tumor or treatment side effects were associated with pain following surgery.

Instead, certain psychological factors were implicated -- with anxiety, depression and trouble sleeping linked to ongoing pain following a mastectomy.

The study also found that "somatization," or psychological distress that is expressed as physical pain, was related to persistent pain after the procedure. The same held true for "catastrophising," or a tendency to fixate about pain and feel unable to cope with it, the researchers said.

The study findings were published in a recent issue of the Journal of Pain.

More information

Visit the American Cancer Society to learn more about mastectomy.

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Breast cancer expert

Dr Gudgeon qualified in Birmingham, England, in 1968. She has more than 40 years experience in oncology, and in 1994 she founded her practice, Cape Breast Care, where she treats benign and malignant breast cancers. Dr Boeddinghaus obtained her qualification at UCT Medical School in 1994 and her MRCP in London in 1998. She has worked extensively in the field of oncology and has a special interest in the hormonal management of breast cancer. She now works with Dr Gudgeon at Cape Breast Care. Read more.

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