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Persistent pain common after breast cancer surgery

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MaryinSarasota View Drop Down
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    Posted: Nov 16 2009 at 8:46am
This explains a lot for me.

A total of 58 percent of the patients reported sensory disturbances or discomfort, with the most frequently reported areas the axilla (the underarm area), followed by arm, breast area and side of the body. A total of 306 patients (20 percent) with pain had contacted a physician within the prior 3 months for pain complaints in the surgical area.

"Based on the results of our study together with previously reported findings, chronic pain after breast cancer surgery and adjuvant therapy may predominantly be characterized as a neuropathic pain state and probably related to intraoperative injury of the intercostal-brachial nerve. In accordance with these findings, preliminary observations with nerve-sparing techniques may suggest such approaches to reduce the risk of developing a chronic neuropathic pain state. However, such studies need to be larger and more detailed, taking all the different subgroups as studied in our investigation into consideration," the researchers write.


http://www.sciencedaily.com/releases/2009/11/091110171630.htm
53 @ Dx 5/08 Stage 1, grade 3, IDC 1.6 cm, 0 nodes, TNBC, lumpectomy, chemo TAC-6, radiation-34 12/18/08
NED-10/09, PBM w/TE recon. 7/10, removal of TE/infec 8/10. CT chest. Rec fat-graft & stem cells
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unklez View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote unklez Quote  Post ReplyReply Direct Link To This Post Posted: Nov 16 2009 at 10:15am
Thanks Mary, this makes a lot of sense....



Wife Dx: Jul/09. Age: 37. Size: 3cm. BRCA: -ve. Lumpectomy: Aug/09. Micromet 1/9 node. Chemo Start: Sep/09. E5103. DD ACB-> DD Abraxane (Taxol reaction). Zometa (S0307). Canadian Fraction Rads.
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mainsailset View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote mainsailset Quote  Post ReplyReply Direct Link To This Post Posted: Nov 16 2009 at 10:54am
Interesting Mary, I would add that with my dbl that the side where they removed the Lymph nodes was decidedly more prone to what I call nerve shocks and general discomfort. They both healed identically but the node free side was virtually pain free.
My surgeon had taken great lengths to explain to me where to expect pain, why it was there and sort through the meaning of each twinge. He also described in detail what kind of useage I could expect and what areas would likely never recover complete strength. He also warned me that the first few days out of surgery I would likely coast then the pain would come in waves and I could expect week 2-3 to be uncomfortable. That was the only advice he was wrong about, I didn't have more pain, just less.
 
I found the initial nerve shocks to be the most painful and always ambushed me. As I did more exercises they faded quite rapidly. Now I'll get an occasional twinge nothing more.
dx 7/08 TN 14x6.5x5.5 cm tumor

3 Lymph nodes involved, Taxol/Sunitab+AC, 5/09 dbl masectomy, path 2mm tumor removed, lymphs all clear, RAD 32 finished 9/11/09. 9/28 CT clear 10/18/10 CT clear
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Lillie View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lillie Quote  Post ReplyReply Direct Link To This Post Posted: Nov 17 2009 at 9:05am
Hi Mary, Mainsailset & Unklez,

I had my surgeries in June of 2006. Left side mastectomy, sentinel node followed a week later by axillary dissection. For about 1 year I had pain, both in the scar and under my arm. I'm with you Mainsailset. Although I read about the nerve shocks in Dr. Susan Love's book and was, I though prepared, they were the worst. I don't have those anymore. I do have, in varying degrees, discomfort or pain, mostly under my arm. At times I have slight lymphodema under my arm and that is uncomfortable. When I have my prosthesis on is when I have the least pain, but most times I can hardly wait to get it off (it's hot and sweaty). I think It helps balance my body and that is why I feel less discomfort.

After 3 years I am not speaking as a statistic, I am speaking as an active participant. I am not complaining, I feel lucky in so many respects, but I have come to the conclusion that once you have breast surgery of any kind especially with node removal there will always be some unwanted discomfort of one kind or another.

I cannot speak for the girls who have had reconstruction, I haven't experienced that. I'm sure their story is different from mine.

Lillie
Dx 6/06 age 65,IDC-TNBC
Stage IIb,Gr3,2cm,BRCA-
6/06 L/Mast/w/SNB,1of3 Nodes+
6/06 Axl. 9 nodes-
8/8 thru 11/15 Chemo (Clin-Trial) DD A/Cx4 -- DD taxol+gemzar x4
No Rads.
No RECON - 11/2015-9 yrs NED
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MaryinSarasota View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote MaryinSarasota Quote  Post ReplyReply Direct Link To This Post Posted: Nov 17 2009 at 9:26am
I didn't read Dr. Love's book so I didn't expect the pain to last so long. I haven't had a reconstruction. I just thought I was being a wuss and hypochondriac (still am.) I have full range of motion in my arm but it seems as the day goes on it gets really tight and hurts like crazy. I didn't realize it was nerve pain. I had both my shoulder joints replaced due to avascular necrosis (osteonecrosis) from steroid use as a child. That didn't hurt as long. Well, I cannot fix it but at least I know what is going on. Thanks for putting your thoughts out there.
53 @ Dx 5/08 Stage 1, grade 3, IDC 1.6 cm, 0 nodes, TNBC, lumpectomy, chemo TAC-6, radiation-34 12/18/08
NED-10/09, PBM w/TE recon. 7/10, removal of TE/infec 8/10. CT chest. Rec fat-graft & stem cells
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Lillie View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Lillie Quote  Post ReplyReply Direct Link To This Post Posted: Nov 17 2009 at 12:34pm
Hi Mary,

You are not a wuss or a hypocondriac.... You just want some affirmation that you are not the only person having discomfort (pain) (a year later).

A friend of mine came rushing over soon after I was diagnosed with the Dr. Love breast cancer book. I put it in a drawer for several months... the last thing I wanted to do during treatment was to read books about cancer. It was only after I finished my treatments that I got the nerve to read anything. I was having the "nerve shock" pains and was comforted to read that it can be completely normal and may continue for some time.

If you experience tightness with the pain it could be lymphodema.

Is there any swelling or puffiness under your arm or down your arm. Also, do you have numbness on the underside of your arm, usually down to the elbow. (I am assuming 1 or more lymph nodes were removed?)

I have the above symptoms in varying degrees every day. If someone grabs or puts their hand around the upper portion of my left arm I always react because it is very uncomfortable. Also, at times (like today) the puffiness under my arm is worse than other times and the two places where the drainage tubes were placed are very sensitive to touch. I have learned over time that it is something I probably will have to endure.

Have you discussed your pain with your oncologist, surgeon or GP. I know that my TN status makes me question a lot of things I might not otherwise.

Good Luck and I hope your pain becomes less (soon)...

Lillie



Dx 6/06 age 65,IDC-TNBC
Stage IIb,Gr3,2cm,BRCA-
6/06 L/Mast/w/SNB,1of3 Nodes+
6/06 Axl. 9 nodes-
8/8 thru 11/15 Chemo (Clin-Trial) DD A/Cx4 -- DD taxol+gemzar x4
No Rads.
No RECON - 11/2015-9 yrs NED
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MaryinSarasota View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote MaryinSarasota Quote  Post ReplyReply Direct Link To This Post Posted: Nov 17 2009 at 1:00pm
Hi Lillie!
You are so sweet. I will give you my husband's phone # and he will confirm the hypochondriac part. lol. I did talk to my Onc and GP about the pain, they sent me to a pain management doc. I type all day at home (radiology MT) and my shoulder just gets pooped. I don't get edema, just the tightness. I too question many things now more than ever since the TN diagnosis. I am doing okay with the medication and will not worry about it being a year later and not being gone yet. Thanks for putting my mind to rest.

I still haven't read Dr. Love's book. For some reason I just thought since we were TN it wouldn't apply. :)

Have a great day Lillie.
53 @ Dx 5/08 Stage 1, grade 3, IDC 1.6 cm, 0 nodes, TNBC, lumpectomy, chemo TAC-6, radiation-34 12/18/08
NED-10/09, PBM w/TE recon. 7/10, removal of TE/infec 8/10. CT chest. Rec fat-graft & stem cells
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trip2 View Drop Down
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Post Options Post Options   Thanks (0) Thanks(0)   Quote trip2 Quote  Post ReplyReply Direct Link To This Post Posted: Nov 18 2009 at 8:33pm
Yes,
 
I had a lumpectomy in 03 and node dissection.  Then when it came back on the other side in 07 I had a bilat with nodes removed.
 
I still have discomfort mostly on my right side from 03.  I have what feels like a muscle grab up near my axilla if I move a certain way.  I do also have Lymphedema issues with my left arm.  But as was said I am not complaining, since the alternative would  have been much worse.
Stage 2 2003
Stage 1 2007
BRCA 1+
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