There are a number of options available to help patients manage mastectomy pain. In addition to clear quality of life benefits, adequate pain management can also decrease hospital stays and reduce the risk of complications. Patients preparing for a mastectomy may want to meet with the surgeon ahead of time to talk about their options, which can include alternative therapies if the patient feels these would be helpful.
Mastectomies are invasive procedures that require removal of all the breast tissue. They can cause considerable pain, especially immediately after the surgery. When the surgery is over and nurses prepare to move the patient to recovery, the anesthesiologist may provide heavy analgesia and can write a prescription for very aggressive pain management. This may include opioids and other medications; often, the treatment involves a combination of drugs to target the pain.
Some patients have concerns about narcotic pain management because they are worried about addiction, especially if they have a family history of addictive conditions. Research suggests that aggressive narcotic pain management immediately after surgery does not pose a high addiction risk, and patients who get high doses early may actually need less mastectomy pain management in the long term. Because pain can be actively detrimental to the healing process, it is also important to focus on treatment of the immediate issue, not potential future risks.
If a patient does not respond to the pain medications on offer, it may be necessary to try different drugs. Patients should report on their mastectomy pain levels to a nurse, who can assess the need for more or different medications. As the patient recovers, the medications can be tapered down and finally stopped entirely. Some patients also find that techniques like acupuncture, herbs, meditation, gentle massage, and other alternative therapies help them with mastectomy pain.
Surgical drains are often left in place after a mastectomy to remove fluids from the site. Patients with mastectomy pain may find it helpful to apply compresses, rest, and elevate the chest to limit swelling and inflammation. It may be difficult to engage in physical activity for the first few days, but as soon as the patient is able, walking around is recommended to limit the chances of a post-surgical blood clot.
A very small number of patients develop a condition called post-mastectomy pain syndrome. This is a form of chronic post-surgical pain caused by nerve damage or the development of a neuroma, an abnormal growth of nerve tissue. These patients can experience continuing pain long after the procedure, and may need evaluation by a pain specialist to discuss other treatment options.