Abstract
Introduction. Pain syndromes affect women after conservative and radical breast oncological procedures. Radiation therapy influences their development. We report autologous fat grafting therapeutical role in treating chronic pain in irradiated patients. Materials and Methods. From February 2006 to November 2014, we collect a total of 209 patients who meet the definition of “Postmastectomy Pain Syndrome” (PMPS) and had undergone mastectomy with axillary dissection (113 patients) or quadrantectomy (96 patients). Both procedures were followed by radiotherapy. We performed fat grafting following Coleman's procedure. Mean amount of adipose tissue injected was 52 cc (±8.9 cc) per breast. Seventy-eight in 209 patients were not treated surgically and were considered as control group. Data were gathered through preoperative and postoperative VAS questionnaires; analgesic drug intake was recorded. Results. The follow-up was at 12 months (range 11.7–13.5 months). In 120 treated patients we detected pain decrease (mean ± SD point reduction, 3.19 ± 2.86). Forty-eight in 59 patients stopped their analgesic drug therapy. Controls reported a mean ± SD decrease of pain of 1.14 ± 2.72. Results showed that pain decreased significantly in patients treated (p < 0.005, Wilcoxon rank-sum test). Conclusion. Our 8-year experience confirms fat grafting effectiveness in decreasing neuropathic pain.
Highlights
Pain syndromes affect women after conservative and radical breast oncological procedures
The present review aims to report our experience in treating chronic pain in irradiated breasts collected after an 8-year experience confirming autologous fat grafting role in improving pain control in patients affected by Postmastectomy Pain Syndrome” (PMPS)
We collected a total of 209 patients; 113 patients were submitted to mastectomy with axillary dissection, while 96 patients were submitted to quadrantectomy
Summary
Pain syndromes affect women after conservative and radical breast oncological procedures. Chronic pain affects from 25% to 60% of women submitted to breast surgery, both mastectomy and conservative procedures for oncological reasons, and represents an important clinical problem involving intra- and postoperative factors [1]. This condition, named Postmastectomy Pain Syndrome (PMPS), is situated in the anterior side of the thorax, in the axilla, and/or in the upper half of the arm and lasts more than 3 months after mastectomy or quadrantectomy surgical procedures [2]. Several risk factors have been advocated to explain the development of PMPS [3] such as axillary lymph node dissection [4], chemotherapy agents [5], and postsurgical complications such as infection, seroma, or hematoma.
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