[4] PMPS pain has been described as searing, excruciating cold, or electric shock feelings, as well as numbness, tingling, or pins and needles.
[5] The development of a traumatic neuroma or scar tissue after the breast cancer surgery, or direct nerve injury, such as transection, compression, ischemia, stretching, and retraction, might result in postmastectomy pain syndrome.
[12] Other risk factors include prior surgery site pain, lower educational attainment, recurrent somatization, sleep disturbances, and axillary dissection.
[14] This could be explained by the fact that younger women with breast cancer had worse prognoses in terms of the tumor's aggressiveness and the possibility of a recurrence.
Frequent headaches are thought to cause a condition of central hypersensitivity, which is initially only functional but may become more permanent as a result of neural plasticity prolonging the pain process.
The cutaneous lateral branch of T2, known as the intercostobrachial nerve, passes through the serratus anterior muscle and innervates the axillary region and upper arm.
[3] Numerous modes of injury during axillary dissection, including as stretching or compression during retraction and frank transection, are linked to damage to the intercostobrachial nerve.
[25] Because traumatic neuromas are frequently seen close to the surgical scar and have characteristics including an oval form, limited edge, parallel orientation, and hypoechogenicity, ultrasound may be utilized to assess them in breast cancer patients who have had mastectomy.
[30] The development of mild to severe PMPS after surgery is highly correlated with preoperative anxiety and depression, according to numerous long-term observational studies and systematic reviews.
[31][32] Multidisciplinary professionals such as psychiatrists, psychologists, counselors, medical social workers, and community support are involved in the management of psychological disorders.
[33] Neuropathic pain resulting from injury to the nerves in the axilla and/or chest wall during surgery is one of the most widely recognized causes of PMPS.
[46][47] The naturally occurring alkaloid capsaicin, which is present in chillies, is a TRPV1 antagonist that reduces substance P in small fiber neurons, which attenuates pain signals and their transmission.
[52][53] Post-mastectomy pain syndrome has often been misdiagnosed and poorly treated;[7] yet, some investigations have shown a gradual decrease in both the severity and related sensory abnormalities over time.