Abstract
Abstract Introduction: After breast cancer surgery, many women may present quality of life (QOL) impairment due to the presence of discomfort as dysesthesia in the anterolateral region of the chest, armpit and/or medial part of the arm caused by intercostobrachial nerve injury (ICBN). Objective: To investigate the effects of Transcutaneous Electrical Nerve Stimulation (TENS) on dysesthesia intensity at the intercostobrachial nerve (ICBN) dermatome and QOL in women after breast cancer surgery. Methods: A randomized, double-blinded, placebo controlled clinical trial was conducted. Women undergoing axillary lymphadenectomy (AL), with dysesthesia on ICBN dermatome were included. Patients were divided into active and placebo TENS groups. TENS was applied with a frequency of 100 Hz, pulse duration of 100 µs and amplitude at the highest sensory intensity tolerable for 20 minutes during 20 sessions, three times a week, on alternating days. In the placebo TENS group, electrical current was delivered only during the first 45 seconds of application. Skin sensitivity was assessed by esthesiometry. Dysesthesia intensity was assessed with a visual analogue scale (VAS) and QOL with the EORTC QLQ-C30 and the specific EORTC QLQ-BR23 which is the Breast Cancer Module. Results: VAS decreased significantly over the 20 sessions in the active TENS group (p<0.006) and no difference was found between groups. There weren’t significant differences in EORTC QLQ-C30 and EORTC QLQ-BR23 after 20 sessions or between groups. Conclusion: TENS decreased dysesthesia intensity in the ICBN dermatome after breast cancer surgery, but did not improve quality of life.
Highlights
Introduction: After breast cancer surgery, many women may present quality of life (QOL) impairment due to the presence of discomfort as dysesthesia in the anterolateral region of the chest, armpit and/or medial part of the arm caused by intercostobrachial nerve injury (ICBN)
Post-mastectomy pain syndrome (PMPS) is defined as chronic pain for over a 3-month period [2,3,4,5, 7] PMPS is different from other painful syndromes because it is typically localized in axillary region and/or medial arm and anterior or lateral region of the chest, causing pressure sensation or numbness, burning and/or shooting pain [2,3,4, 7]
Not different from placebo, according to the methods used in the research, Transcutaneous Electrical Nerve Stimulation (TENS) could decrease dysesthesia intensity in the ICBN dermatome after breast cancer surgery, but did not improve the quality of life
Summary
Many women may present quality of life (QOL) impairment due to the presence of discomfort as dysesthesia in the anterolateral region of the chest, armpit and/or medial part of the arm caused by intercostobrachial nerve injury (ICBN). Post-mastectomy pain syndrome (PMPS) is defined as chronic pain for over a 3-month period [2,3,4,5, 7] PMPS is different from other painful syndromes because it is typically localized in axillary region and/or medial arm and anterior or lateral region of the chest, causing pressure sensation or numbness, burning and/or shooting pain [2,3,4, 7] It is caused by either primary lesion or dysfunction in the nervous system and is considered a neuropathic condition that arises after surgical treatment for breast cancer. This can occur due to intercostobrachial nerve (ICBN) lesion, neuroma and lesions of other nerves [3]
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