Postmastectomy neuropathic pain: results of microsurgical lymph nodes transplantation

Breast. 2008 Oct;17(5):472-6. doi: 10.1016/j.breast.2007.12.007. Epub 2008 May 1.

Abstract

Postmastectomy chronic pain may be divided into widespread and regional pain. Almost half patients with regional pain, which is more likely related to neuropathic phenomena, do not benefit any pain relief from medication. Our purpose was to report results on pain relief obtained by axillary lymph nodes autotransplantation.

Methods: Six patients presented with chronic regional neuropathic pains and upper limb lymphedema after breast cancer surgery and radiation therapy. Despite medication, pain was intolerable and daily activity dramatically reduced. Lymph nodes were harvested in the femoral region, transferred to the axillary region and transplanted by microsurgical procedures.

Results: Lymphedema resolved in 5 out of 6 patients. Pain was relieved in all, permitting return to work and daily activity; analgesic medication was discontinued.

Conclusion: This procedure proved efficient and may be advocated in case of neuropathic pain when discussing lymphedema management.

MeSH terms

  • Aged
  • Breast Neoplasms / radiotherapy
  • Breast Neoplasms / surgery
  • Humans
  • Lymph Nodes / transplantation*
  • Lymphedema / complications
  • Lymphedema / etiology
  • Lymphedema / surgery*
  • Mastectomy / adverse effects*
  • Microsurgery / methods*
  • Middle Aged
  • Neuralgia / etiology
  • Neuralgia / surgery
  • Pain Measurement
  • Pain, Postoperative / etiology*
  • Time Factors
  • Treatment Outcome