Breast Cancer - Arab Medical Association Against Cancer

Persistent Pain 224Neuropathic PainIt is believed to be sustained by a site of aberrant somatosensory processing in theperipheral or central nervous system, most strongly suggested when there is asensory affection in the form of hypoesthesia, dysesthesia, or allodynia, sometimeswith loss of sensation and burning form of pain.Pathogenesis of Pain SyndromesSyndrome Causes Percentage1. Postmastectomy pain Surgical differentiation 19%2. Intercostal Neuralgia Herpes Zoster 7%Rib metastasis 5%3. Heavy painful arm Irradiation fibrosis 19%Axillary recurrence 7%4. Low back pain L1 metastasis 5%L4, 5 sacroiliac metastasis 7%5. Joint pain Hip, femur 7%Shoulder & humorous 5%6. Upper abdominal pain Liver metastasis 12%7. Neuralgias Sciatic & ulnar neuralgia 7%Acute Pain SyndromesAcute pain in breast cancer is usually related to patient’s management, and can beprevented. Acute pain hospital service should be available to prevent the occurrenceof these forms. Pain is usually simple, cause-related, and has a short duration. Acutepain syndromes associated with breast cancer are:• Pain associated with diagnostic interventions e.g. Myelography,Percutaneous biopsy.• Postoperative pain.• Pain associated with chemotherapy infusion techniques as intravenousinfusion pain due to venous spasm, chemical phlebitis or extravasation.• Pain associated with chemotherapy toxicity e.g. mucositis, corticosteroidinduced perineal discomfort.