Evaluation of Post-Mastectomy Pain and Functional Outcome after Surgery for Early Breast Cancer

Objective: This study was designed to evaluate post-mastectomy functional outcome as regards the frequency and severity of post-mastectomy pain syndrome (PMPS), occurrence of lymphedema (LE), occurrence of shoulder motion restriction, physical and psychological welfare after different types of surgery for early breast cancer. Patients and Methods: The study comprised 28 patients with early breast cancer divided into 3 groups according to operative procedure indicated; modified radical mastectomy (group A), pectoralis minor preservation mastectomy (group B) and breast conservative surgery (group C). Postoperative follow-up was conducted every 3 months for PMPS using McGill Pain Questionnaire, pain severity was recorded using 4-point verbal analogue scale. The frequency of occurrence and the degree of LE was reported using sequential circumferential measurements. Psychological and physical welfare was determined using a 4-subscale questionnaire. Results: 10 patients (35.7%) had PMPS with a non-significant difference between the three applied procedures as regards both the frequency and severity of PMPS. 2 patients in group A had painful shoulder with significant reduction of shoulder abduction and external rotation. Six patients (21.4%) developed LE with significant increase in the mean difference in arm circumference in group A & B compared to group C. Patients included in group C had significantly higher scores of psychological and physical welfare compared to other groups. Conclusion: It could be concluded that PMPS is not strictly related to the type of surgical procedure and whenever indicated breast conservative surgery has better functional outcome with the least incidence of complications. (Egypt J. Neurol. Psychiat. Neurosurg., 2007, 44(1): 111-122).