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Managing Cancer Care

Post-mastectomy Pain Syndrome

After having breast cancer surgery, some women have problems with nerve (neuropathic) pain in the chest wall, armpit, and/or arm that doesn’t go away over time. This is called post-mastectomy pain syndrome (PMPS) because it was first noticed in women who had mastectomies, but it can also happen after other types of breast-conserving surgery (such as a lumpectomy).

Symptoms of PMPS

The classic symptoms of PMPS are pain and tingling in the chest wall, armpit, and/or arm. Pain may also be felt in the shoulder or surgical scar. Other common complaints include: numbness, shooting or pricking pain, or unbearable itching. Most women with PMPS say their symptoms are not severe.

How common is PMPS?

Studies have shown that between 20% and 30% of women develop symptoms of PMPS after surgery. It's most common after operations that remove tissue in the upper outside portion of the breast or the underarm area.

PMPS is thought to be linked to damage done to the nerves in the armpit and chest during surgery. But the causes are not known for sure. Women who are younger, who have had a full axillary lymph node dissection (ALND) and not just a sentinel lymph node biopsy, or who were treated with radiation after surgery are more likely to have problems with PMPS. Because ALND is done less often now, PMPS is less common than it once was.

Managing PMPS

It is important to talk to your doctor about any pain you are having. PMPS can cause you to not use your arm the way you should, and over time you could lose the ability to use it normally.

PMPS can be treated. Some pain medicines, even some as strong as opioids (narcotics) don't always work well for nerve pain, but there are medicines and treatments that do work for this kind of pain. Talk to your doctor to get the pain control you need.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Along with the American Cancer Society, other sources of information and support include:

National Cancer Institute
Toll-free number: 1-800-4-CANCER (1-800-422-6237)
Website: www.cancer.gov

  • Offers current information about breast cancer screening, diagnosis, and treatment as well as information on other types of cancer, as well as information for the family and children of people with cancer

National Comprehensive Cancer Network (NCCN)
Website: www.nccn.org/patients

  • Made up of experts from many of the nation’s leading cancer centers, the NCCN develops guidelines for doctors to use when treating patients. Some of these guidelines, including one on breast cancer, are available in versions for patients as well. Also provides online information on other topics to help patients, caregivers, and families make informed decisions about cancer care.

Susan G. Komen for the Cure
Toll-free number: 1-877-465-6636
Website: www.komen.org

  • Offers information on breast health and breast cancer; tools, including videos and quizzes; and referrals to support groups. Some written materials in Spanish, Arabic, Chinese, Vietnamese, Russian, and Korean

*Inclusion on this list does not imply endorsement by the American Cancer Society.

Grossman SA, Nesbit S. Cancer-related Pain. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 5th ed. Philadelphia: Elsevier, 2014:608-619.

Johannsen M, Christensen S, Zachariae R, Jensen AB. Socio-demographic, treatment-related, and health behavioral predictors of persistent pain 15 months and 7-9 years after surgery: a nationwide prospective study of women treated for primary breast cancer. Breast Cancer Res Treat. 2015;152(3):645-658.

Leysen L, Beckwée D, Nijs J, et al. Risk factors of pain in breast cancer survivors: a systematic review and meta-analysis. Support Care Cancer. 2017;25(12):3607-3643.

Wolff AC, Domcheck SM, Davidson ND, Sacchini V, McCormick B. Cancer of the Breast. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 5th ed. Philadelphia: Elsevier, 2014:1630-1692.

Last Revised: January 3, 2019

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