Being Younger, Axillary Node Surgery Linked to Chronic Pain After Breast Cancer Surgery

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Up to 60% of women who have surgery to remove breast cancer have pain that lasts months or years after the incisions have healed.

A study suggests that having axillary lymph node surgery, where three or more lymph nodes in the armpit area are removed, and being younger are associated with pain lasting 2 months or more after breast cancer surgery.

The research was published online on July 11, 2016 by CMAJ, the Canadian Medical Association Journal. Read the abstract of “Predictors of persistent pain after breast cancer surgery: a systematic review and meta-analysis of observational studies.”

This study was a meta-analysis -- a study that combines and analyzes the results of many earlier studies. In this case, the results of more than 19,800 women in 30 studies on persistent pain after breast cancer surgery done before March 12, 2015 were analyzed.

The researchers found 77 factors that were linked to persistent pain after breast cancer surgery. The factors that had the highest risk of persistent pain were:

  • axillary lymph node surgery
  • being younger when surgery was done

The researchers found no link between persistent pain and body mass index, type of breast cancer surgery, chemotherapy, or hormonal therapy.

"Our analysis found that women who undergo surgery for breast cancer are much more likely to develop chronic pain if surgeons cut through nerves when performing axillary lymph node dissection to remove the tumor," said Dr. Jason Busse, assistant professor of anesthesia at McMaster University.

Still, the researchers wrote that it’s not clear if sparing nerves during breast cancer surgery will prevent chronic pain from developing. More research is needed to understand how different surgery techniques may ease or aggravate chronic pain after breast cancer surgery.

While the results of this study are troubling, it is good to know that current treatment standards recommend sentinel lymph node surgery -- where only the one or two nodes closest to the cancer is removed and examined -- for many women.

There were also encouraging results published in June 2016 showing that mindfulness-based cognitive therapy, a specific type of counseling, helps ease pain after breast cancer treatment.

It’s important to know that treatment for pain is part of cancer treatment. You and your medical team should have a plan in place for treating any pain you may experience before, during, or after your treatment for breast cancer. Most people can get complete relief for their pain -- or at least significant relief that allows them to enjoy the activities of daily life. It may take some time to find the right combination and types of pain treatment that work best for you, but the effort will be worth it.

For more information on pain causes and treatments, visit the pages on Treatments for Pain.

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