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Post-Breast Surgery Pain Syndrome Treatment with Targeted Muscle Reinnervation
Kenny T. Quang, MD, Meghan Brown, MD, Douglas Wagner, MD, Lewis Diulus, MD, Shayda Mirhaidari, MD
Summa Health System plastic surgery
2023-02-08
Presenter: Kenny Quang
Affidavit:
Kenny has performed 100% of the work associated with the abstract
Director Name: Ananth Murthy
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background:
As breast surgeries have become more common, so has the prevalence of chronic pain issues. Post-mastectomy pain syndrome has been described but given that this phenomenon occurs even in non-cancer operations, it has been broadened to post-breast surgery pain syndrome. The definition and criteria varies depending on the literature.
It is theorized that the pain is from nerve injury or neuroma formation. Thus, targeted muscle reinnervation may prove to be a viable treatment in these patients. The purpose of this article is to discuss our experience with targeted muscle reinnervation as a treatment for post-breast surgery pain syndrome
Methods:
A retrospective chart review was performed at a single institution where we focused on preoperative pain and postoperative outcomes after targeted muscle reinnervation after breast surgery between January 2016 to December 2022.
Results:
Over a 6 year period, a total of 13 patients underwent previous breast surgery and subsequent targeted muscle reinnervation for chronic pain. A total of 15 anastomoses were performed. In each patient, a neuroma was identified and excised. One patient had a medial intercostal nerve that was anastomosed to a rectus motor branch. All others were more lateral intercostal sensory branches that were anastomosed to a serratus motor branch. The overall pain score preoperatively ranged from 1-10 with the majority rated at 3-4. All had pain score of 0 post operatively. One patient continued to have residual discomfort but less frequent and intense.
Conclusion:
Targeted muscle reinnervation for patients suffering from post breast surgery pain syndrome can be a highly effective form of treatment
