According to a study published in the November 11 issue of the Journal of the American Medical Association by Rune Gärtner, MD, and colleagues, pain for two to three years after auxillary lymph node dissection surgery continues to be common.
Loretta S. Loftus, MD, MBA, and Christine Laronga, MD, both of the H. Lee Moffitt Cancer Center in Tampa, Fla., wrote that recognizing the predictors may help doctors start therapy earlier. “Management requires a multidisciplinary approach that includes evaluation by surgeons, medical oncologists, radiation oncologists, pain management specialists, psychologists, social workers and experts in rehabilitation medicine,” they said.
Although sentinel node dissection has reduced pain complaints after surgery, attention should focus on nerve-sparing techniques in particular, Gärtner's group added. Post-surgical pain can stem from nerve damage that results in inter-costobrachial neuralgia, neuroma pain, phantom breast pain, or from compression injury to the brachial plexus due to lymphedema, or even from a second primary tumor.
Further study is needed to determine how pain and sensory disturbances will develop or ease over time.