Lasting pain after breast surgery or lymph node removal

1. Causes of lasting pain
2. Managing pain
3. Support if you're in pain

1. What causes lasting pain after breast surgery or lymph node removal?

Some people have pain in their breast, chest, arm or armpit for months or even years after they had surgery. 

It can happen after any type of breast surgery, including a lumpectomy (wide local excision), mastectomy, lymph node removal and breast reconstruction. 

The pain is usually caused by bruising, stretching or damage to nerves during surgery or when scar tissue forms. 

It seems to affect more people who have had surgery to the upper outer part of the breast and the armpit. These areas are particularly vulnerable to nerve injury.

Research suggests that lasting pain is more common in people who:

• had their lymph nodes removed (rather than a sentinel lymph node biopsy alone)
• had severe pain immediately after surgery that wasn’t well controlled
• had lasting pain before surgery, whatever the cause or wherever in the body
• had radiotherapy to the lymph nodes
• are overweight 

2. Managing pain

Tell your GP or treatment team about any ongoing pain, so they can assess it and help you manage it.

The Pain Support website has some tips on getting the most out of this discussion. 

The NHS website has information about getting help with lasting pain.

Pain relief

Regularly taking simple pain relief, such as paracetamol or ibuprofen, either as a tablet or applied to the skin, may help.  

If it doesn’t, let your hospital team or GP know. They may suggest stronger medication such as antidepressants or anti-epileptic drugs, which have been shown to help with nerve pain.

Exercise and physiotherapy

Regular exercise has been shown to ease lots of types of pain. 

Some people may need to be referred to a physiotherapist. They can help work out an exercise plan for you to improve movement and build up strength. Speak to your GP about how physical activity may help.

Complementary therapies

Some studies show that acupuncture may help reduce pain after breast cancer surgery. 

Complementary therapies such as massage, reflexology and reiki can help create an overall sense of wellbeing. 

Speak to your specialist team before trying a complementary therapy.

Talking therapies and self-help techniques

Talking therapies, such as counselling and cognitive behavioural therapy (CBT), can help you find new ways to think about pain and the impact it has and may also reduce worry and anxiety.

Some people practise self-help techniques such as relaxation, meditation and distraction. These can help with managing pain and improve wellbeing in general.

Find out more about these techniques.

You can read more information about CBT on the NHS website.

Wearing a well-fitting bra

Wearing a well-fitting bra may make a difference if you’re in pain. You may need help trying different styles. You could look in your nearest supermarket, department or lingerie store, or you may prefer to use specialist suppliers.

Download our guide to a well-fitting bra.

Pain clinics

If your GP or hospital doctor cannot control your pain, you may benefit from going to a specialist pain clinic. You can ask your GP to refer you. 

At the pain clinic, you may see a doctor with a special interest in pain, or you might see a range of different healthcare professionals such as a doctor, nurse, physiotherapist and occupational therapist.

Some pain clinics run a pain-management programme (PMP). The programme aims to help people improve their quality of life by developing ways of living with pain. This is usually used if pain continues after other treatments have been tried.

Phantom breast and nipple pain

Phantom breast and nipple pain is pain that feels as if it’s coming from the breast and nipple that have been removed. The pain and discomfort can feel like pressure, itching, throbbing or pins and needles.

Phantom breast pain can happen straight after surgery or sometimes up to a year later. Because the pain is caused by damage to the nerves at the time of surgery, the most effective types of pain relief are those used to treat nerve pain, such as antidepressants or anti-epileptic drugs.

If you have phantom breast and nipple pain and simple pain relief doesn’t help, talk to your GP or treatment team.

3. Support if you’re in pain

Managing pain can be difficult, and there may be times when you feel unable to cope. 

If you want to talk things through, you can call our Helpline free on 0808 800 6000. 

Our Someone Like Me service can put you in touch with someone who has had a similar experience to you, to talk about pain and other side effects.