Infiltración con toxina botulínica para el control del dolor en cáncer de mama

Abstract

IntroductionPain is common among patients with breast cancer, it being the leading cause of poor quality of life. Botulinum toxin (BT)may be a treatment option in these patients during breast reconstruction or in post-mastectomy pain syndrome. Very few authors have studied its effectiveness in treating pain. HypothesisInfiltration with BTin the breast muscle causes an inhibition of the muscle spasm, thus improving the pain. ObjectivesTo assess the effectiveness of BT in pain control in reconstruction with tissue expanders, breast implants and in chronic pain. Material and methodsThe study had a quasi-experimental design. The sample included 89 randomly selected patients between June 2009 and February 2011. All had breast cancer with controlled disease and painful contracture of the pectoralis major. The evaluation was performed by clinical examination and score on the visual analogue scale (VAS) before and after the infiltration. ResultsA total of 21% had undergone infiltration during reconstruction; 16% had a breast prosthesis and 63% had chronic pain. Nociceptive pain was more frequent in the expander (73.6%) and mixed chronic pain (89.2%) group. Initial VAS score was higher for the expander group that obtained greater declines after the injection. ConclusionsInfiltration of the pectoral muscle with BT type A improves pain in breast cancer subjects, both during breast reconstruction with expander and in patients with implants and in those with post-mastectomy pain syndrome.