Phantom Pain Following Mastectomy

Phantom breast pain and other sensations occur in about a third of all mastectomy patients following surgery and can persist for months, as though the breast had never been removed. This research finding was reported at the annual meeting of the American Society of Anesthesiologists in San Francisco. The study also found that having breast reconstruction surgery after mastectomy does not reduce the likelihood that such sensations will occur.

The study involved 504 women who had mastectomies between 1996 and 1999. Of the 279 who responded, 48% chose cosmetic surgery and 52% chose mastectomy alone. Of the respondents, 39% reported phantom breast pain (PBP) and 31% reported phantom breast sensations (PBS). Common phantom sensations reported were itching, throbbing, "pins and needles” sensations and feelings of pressure. The major predictor of PBS and PBP was the presence of breast pain prior to mastectomy, said the researchers. Breast pain before surgery doubled the incidence of both.

Women aged 60 and over reported significantly less pain than women under 60. About half of the women surveyed also reported pain after mastectomy in other regions of the body such as the arm and chest wall. Again, choice of surgery did not influence the likelihood of experiencing pain in these regions.

The study also explored the impact of the two types of surgery on women's ability to function. Although the women in the breast reconstruction group reported significantly more muscle weakness and numbness than those in the mastectomy alone group (82% versus 65%), the two groups did not differ in their ability to function.

"We thought having a replacement breast would lower the incidence of phantom pain and sensations,” said Srinivasa raja, M.D., an anesthesiologist at Johns Hopkins University (Baltimore, MD, USA) who participated in the study. "We hope this new information will help women with breast cancer make more informed choices regarding their treatment.”