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What causes pain around axillary area after a breast mastectomy?

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Posted on Mon, 2 Mar 2015
Question: I had a left breast mastectomy ,21 lymph nodes removed all negative with immediate reconstruction due to invasive ductal carcinoma in October 2013, taking Arimidex 1mg daily, no other medications except Vitamins. Have been consistantly in good health but began having intermittant stabbing /burning pain of short duration about six inches below the axillary area on the left about 7/8 weeks ago which is positional in nature eg upon turning in bed to either side, sometimes upon reaching up or down, sometimes on bending but not consistantly and when exercizing 3x a week @ Curves the discomfort though very intense when it occurs subsides immediately and the source location is sometimes tender and other times hard to locate . I told my Oncologist about this pain and was to see my Surgeon this past week but the appointment was cancelled due to snow . I will reschedule but wonder if I should see my family physician first. I am wondering if this could be post herpetic neuralgia(even if I have not had any evidence of Shingles lesions)I have had two very mild cases of Shingles the last 4 years ago,with only three lesions on my neck and no pain associated only tingling both times . I have been able to tolerate this pain thus far ,hoping it will run its course . Would love to have a resolution and know what I am dealing with?
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Answered by Dr. Luchuo Engelbert Bain (1 hour later)
Brief Answer:
No worries, pain control, see family Dr

Detailed Answer:
Hi and thanks for the query,

I understand this could really be very disturbing. The good news is you can at least tolerate it as you wait to see your oncologist.

There are two key points in my opinion I would love to bring out. It is important to note if you have had lately any skin eruptions or change in color around the area where the pain occurs. If not, it unlikely that this should be post herpetic neuralgia. In post herpetic neuralgia generally, this is usually a permanent pain, not actually affected by a change in position. It is true that a past history of cancer could be a favoring ground to develop shingles or neuralgia of this origin, but in your case, in my opinion, this is very unlikely.

Secondly, the fact that the pain changes with a change in position could imply it is mechanical/contact in nature. A local inflammation around this area has to be properly checked. Doing a simple and proper clinical review , a chest X ray and follow up blood tests should be good starting points.

I really do not think you need to be too weary as you wait to see your oncologist. You can see your family physician first of course. It is reassuring in you experience you serious signs and symptoms like breathlessness, intense fatigue nor a permanent intense pain.

Taking simple analgesics like Acetaminophen , combined with low dose Anti inflmammatory drugs like Ibuprofen (if you have no history of gastritis or peptic ulcer disease) could be temporal measures as you wait to see your doctor.

Thanks and kind regards as I wish you the best f health. Should you have any further questions please, I would be glad to contribute.

Kind regards,

Dr Bain
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Luchuo Engelbert Bain

General & Family Physician

Practicing since :2009

Answered : 3092 Questions

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What causes pain around axillary area after a breast mastectomy?

Brief Answer: No worries, pain control, see family Dr Detailed Answer: Hi and thanks for the query, I understand this could really be very disturbing. The good news is you can at least tolerate it as you wait to see your oncologist. There are two key points in my opinion I would love to bring out. It is important to note if you have had lately any skin eruptions or change in color around the area where the pain occurs. If not, it unlikely that this should be post herpetic neuralgia. In post herpetic neuralgia generally, this is usually a permanent pain, not actually affected by a change in position. It is true that a past history of cancer could be a favoring ground to develop shingles or neuralgia of this origin, but in your case, in my opinion, this is very unlikely. Secondly, the fact that the pain changes with a change in position could imply it is mechanical/contact in nature. A local inflammation around this area has to be properly checked. Doing a simple and proper clinical review , a chest X ray and follow up blood tests should be good starting points. I really do not think you need to be too weary as you wait to see your oncologist. You can see your family physician first of course. It is reassuring in you experience you serious signs and symptoms like breathlessness, intense fatigue nor a permanent intense pain. Taking simple analgesics like Acetaminophen , combined with low dose Anti inflmammatory drugs like Ibuprofen (if you have no history of gastritis or peptic ulcer disease) could be temporal measures as you wait to see your doctor. Thanks and kind regards as I wish you the best f health. Should you have any further questions please, I would be glad to contribute. Kind regards, Dr Bain