'PHANTOM' SENSATIONS REPORTED BY ONE-THIRD OF MASTECTOMY PATIENTS
SAN FRANCISCO -- Some women experience "phantom" pain and other sensations after a mastectomy as if the breast had never been removed. Similar to feelings experienced by some leg or arm amputees, these sensations can persist for months.
Research reported at the annual meeting of the American Society of Anesthesiologists indicates that phantom breast pain (PBP) and phantom breast sensations (PBS) occur in about a third of mastectomy patients. The study also found that having breast reconstruction surgery after mastectomy does not reduce the likelihood that these sensations will occur.
"Women who choose to have breast reconstruction surgery after mastectomy are just as likely to experience phantom breast sensations (PBS) and pain (PBP) as women who opt not to undergo breast reconstruction," Srinivasa Raja, M.D., an anesthesiologist at Johns Hopkins University, said.
Researchers sent a questionnaire to 504 women who had mastectomies at the hospital between 1996 and 1999. Of the 279 who responded, 48 percent had chosen cosmetic surgery and 52 percent had chosen mastectomy alone. Of the respondents, 39 percent reported PBS and 31 percent reported PBP.
"The major predictor of PBS and PBP after mastectomy was the presence of breast pain prior to mastectomy. Breast pain before surgery doubled the incidence of postsurgical PBP and PBS," Dr. Raja said.
Patients with and without breast reconstruction reported similar levels of PBS and PBP. Common PBS included itching, throbbing, "pins and needles" sensations and feelings of pressure.
The similar PBS and PBP rates among the two groups surprised the researchers, Dr. Raja said. "We thought having a replacement breast would lower the incidence of phantom pain and sensations," he said.
In addition, women aged 60 years and older reported significantly less pain than women under the age of 60 (53 percent versus 66 percent, respectively).
The women who reported more pain also reported greater fears about the possible recurrence of cancer and greater concerns that the surgery had a negative impact on their sex lives.
About half of the women surveyed reported pain after mastectomy in other regions of the body such as the arm and chest wall. Again, choice of surgery did not influence the likelihood of experiencing pain in these regions, the researchers reported.
The study also explored the impact of the two types of surgery on women's ability to function. Although the women in the breast reconstruction group reported significantly more muscle weakness and numbness than those in the mastectomy alone group (82 percent versus 65 percent), the two groups did not differ in their ability to function despite this discomfort.
The incidence of depression was about the same in the two groups as well, but depression was more common among women from either group who had also experienced pain after mastectomy. The finding is understandable because, in general, patients with chronic pain are more likely to be depressed, Dr Raja said.
"We hope this new information will help women with breast cancer make more informed choices regarding their treatment," Dr. Raja said.
Researchers believe phantom pain is the body's way of responding to the trauma of amputation. When nerves are cut, the trauma triggers the development of new nerve tissues called neuromas. These new growths send abnormal signals to the nervous system, which the brain interprets as pain.
Phantom pain also may represent a reorganization of the central nervous system in response to the sudden absence of input from a given area. Normally, neurons focus on the areas of the body from which they receive signals. When these signals stop coming, neurons in adjacent parts of the body begin sending signals to those neurons as a form of compensation. Breast cancer is the most common type of cancer among women and the second leading cause of death among women.
#
This news release is protected by copyright. American Society of Anesthesiologists attribution is required.Copyright (c) 2000American Society of AnesthesiologistsAll Rights Reserved
This research will be presented at the 2000 American Society of Anesthesiologists (ASA) annual meeting in San Francisco, California, on October 14-18. During the annual meeting, you can reach communications staff members between 8 a.m. and 5 p.m. in the ASA press room at the Moscone Center, Room 228, telephone: (415) 978-3710. ASA staff members will be on hand to assist you in scheduling interviews, locating individuals and providing general background information.
Most of the news releases are embargoed until their presentation date. If you cannot attend the meeting, members of the ASA communications department can assist you in arranging interviews with the presenters prior to the meeting.
For further information prior to the annual meeting, please contact the ASA Executive Office, 520 N. Northwest Highway, Park Ridge, IL 60068-2573, or call (847) 825-5586. We are also available by e-mail: [email protected].
Copies of the ASA annual meeting program book program as well as the scientific abstracts and refresher course outlines will be available in the press room.
For more information about ASA, the 1999 Annual Meeting and the medical specialty of anesthesiology, visit our World Wide Web site: http://www.ASAhq.org
###
RSS