Breast Pain

Chronic breast pain can follow any breast surgery. The most common procedures include:

• mastectomy
• axillary lymph node dissection
• breast reconstruction
• breast reduction
  • breast augmentation
  • breast lift (mastopexy)

Despite the fact that these treatments can all successfully address the original problem, a number of patients can be left with new, nerve related problems. This usually presents as chronic and localized breast and anterolateral chest pain that persists beyond the expected recovery time. From this point, a number of pain treatments are offered to patients by many specialists. Since the vast majority is focused on treating patient symptoms, a solution is seldom found. Unlike other specialties, peripheral nerve surgery is focused on the anatomical cause of chronic pain, ensuring the best possible chance for cure.

You should see Dr. Ducic for chronic Breast Pain following surgery, if your symptoms persist:

• After common reasons for prolonged post-operative pain (infection, bleeding, tumor, pulmonary, and others) have been excluded by your initial surgeon or treating sub-specialist
• Despite medical care prescribed to you by your surgeon or other specialist
• Despite supportive care, such as activity and work adjustments and a negative radiological work-up
• After six months of prescribed medical and conservative care

Patients with chronic breast pain may also report a pins and needles or burning sensation over the involved chest area. Scars from previous surgery may be hypersensitive or painful. Daily activities can be affected. Symptoms may be present at rest and exacerbated with activity. The extent of this presentation may vary, depending on the number of nerves involved and intensity of pain. Failure to intervene in a timely manner poses a risk for the chronic pain to evolve into more complex disorder with involvement of your central and autonomic nervous system, making treatment far more challenging and difficult. Therefore, peripheral nerve surgery has an important role in treating chronic post-operative breast pain, giving patient a chance to eliminate dependence on pain medications and thus improve quality of life. As described in Dr. Ducic’s original and pioneering published studies, based on patient’s presentation and findings on physical exam, the involved sensory nerves are surgically identified and removed so they an no longer generate pain.

During surgery for chronic trunk pain:

1. You will receive anesthesia so you won’t feel any pain during the surgery.
2. An incision is made over the involved chest area(s) to access and remove damaged painful nerves. This can be done through an old scar or may require a new access site. In most cases the involved nerves are primarily sensory nerves, so no motor deficits are expected. The skin is closed in anatomical layers.
3. Ambulation is allowed immediately following the surgery, as tolerated.
4. Peripheral nerve surgery for chronic breast pain is usually an outpatient procedure; your dressing will be removed in about 3-5 days after surgery, while sutures are removed about two weeks later.

If you are not sure about your eligibility for surgery, and if you are not in the Washington, D.C. area, you can send me your records so I can determine if you are a good candidate for treatment. Visit my patient forms page for a downloadable form.