Postmastectomy pain syndrome in our region: characteristics, treatment, and experience with gabapentin

Introduction. Postmastectomy pain syndrome affects up to a half of the patients treated for breast cancer. Aims. Characterization of this syndrome and its evolution. Measure pharmaceutical treatment (specifically with gabapentin). Patients and methods. A retrospective study of 89 patients with more than five years monitoring was carried out. Results. Of the patients included in the study 88% had not been previously diagnosed. The mean age of the patients was 56.49 years old. The pain lasted on average 29.15 months. In 71% the neurological symptoms corresponded to the second intercostobrachial nerve. The average pain value for patients before treatment on the Visual Analog Scale was 66.5 and 13.14 on the Lattinen Index. The treatment with gabapentin at an average dose of 1,135 mg for 14 weeks reduced pain in 80% of the patients (p < 0.0001). In the majority of the patients the reduction was maintained in the long term. Ten percent continued the treatment whereas another 10% suspended treatment due to side effects. The average necessary number of patients to be treated was 2.13. Of those treated with gabapentin 35% relapsed while 15.68% changed medication compared to 50% of those treated with other indicated neuropathic drugs (p = 0.046). No difference in the effectiveness between both groups was found. Conclusions. Postmastectomy pain is an under-diagnosed pathology. Treatment (in particular with gabapentin) can be significantly effective and well tolerated in up to 90% of postmastectomy pain syndrome patients.