A woman who has had a mastectomy or lumpectomy may experience pain at the site of surgery.


Clinical features:

(1) The pain is typically constant, burning and moderate to severe in intensity.

(2) The pain may begin immediately or soon after surgery..

(3) The pain may triggered by touch, clothing or skin traction (allodynia).

(4) Hyperesthesia may be present.

(5) The pain may be poorly controlled by simple nonnarcotic analgesics.

(6) The pain may also involve the ipsilateral axilla and upper arm.

(7) The pain can result in significant disability for the patient.


Differential diagnosis:

(1) infection

(2) carcinoma invading a nerve

(3) phantom breast syndrome (see above)

(4) postherpetic neuralgia

(5) radiation effects


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