Pain after breast surgery

Pain and discomfort are common while your wounds are healing after breast surgery – lumpectomy or mastectomy with or without breast reconstruction.

Pain is usually temporary and becomes less severe over time. It might take several weeks or months before you have completely healed; everyone's experience is different.

There are many options to help you manage pain. It is important to let your treating team know if you are in pain so they can help.

Pain immediately after surgery

Pain after surgery is most often due to injury to the skin and muscle tissue.

Surgery may cause changes in sensation in the chest, armpit, shoulder and arm on the affected side.

Some people may experience:

• pain that is sharp, shooting, burning or aching
• pins and needles, numbness
• sensitivity to touch.

This happens because the nerves to the chest and armpit area are cut or damaged during surgery.

Symptoms usually improve over time as nerves repair themselves. Nerves are slow to heal, though, and in some cases symptoms may take months to improve.

Wearing a supportive bra during the day and at night can help reduce discomfort.

Your shoulder may also become stiff and sore after surgery. Your nurse or physiotherapist will give you information about exercises after surgery to prevent shoulder stiffness and to help your shoulder's range of movement.

How to describe your pain 

It can be hard to describe your pain to your treating team or to other people.

The more accurately you can describe the pain, the easier it is for doctors to prescribe effective treatment. It may be helpful to keep a diary to record the following:

• If 0 is no pain at all and 10 is the worst pain you could imagine, what number is yours?
• What does the pain feel like: a dull ache or more like stabbing or burning?
• Is it constant or does it come and go (intermittent)?
• If it comes and goes, when is it at its worst and how long does it last?
• Is it easy to pinpoint where the pain is or is it more general?
• Does anything provide relief or make it worse?
• If you have tried medications, did any work better than others?

It’s unlikely you’ll experience all of these, but we explain types of pain and ways to reduce their impact:

• Pain after breast surgery
• Pain as a side effect of radiotherapy and chemotherapy
• Pain after you finish treatment.

Tell your doctor if you experience pain so they can help you manage it. They may recommend an approach that includes medication, exercise and psychosocial support.

Complementary therapies may also be helpful with DCIS pain. Always check with your doctor before you start any complementary or alternative treatments.

Treating pain after surgery

Different types and strengths of pain medication are available. They may be given as injections, tablets or suppositories. Sometimes pain medications are given directly into your vein (intravenously).

Your doctor will carefully monitor the amount you are taking, to make sure it is safe for you. It is important to follow your doctor's recommendations.

Mild pain

Painkillers for mild pain include paracetamol or ibuprofen (anti-inflammatory drugs). These are available over-the-counter. It is always important to check with your doctor to ensure these are safe for you to take.

Severe pain

Slow-release opiates such as Tapentadol or Oxycodone can be given for strong pain immediately after surgery. You may have this once or twice a day for a short time until the pain eases.

Fast-release strong painkillers such as Panadeine Forte or opiates (e.g. Endone) may also be prescribed.

Sometimes you may have pain relief through a pump called a PCA (patient-controlled analgesia). This is more common if you have a breast reconstruction. It provides pain relief into your vein (intravenously) and gives you a safe dose of your pain medicine when you push the button.

Different types of medication can also help with nerve pain - often described as shooting or burning pain.

Side effects of pain-relieving drugs include constipation so you may need medication to promote regular bowel movements. Ensure that you eat high-fibre foods, drink plenty of water and do gentle exercise (including post-operative arm and shoulder exercises) as directed by your treating team.