Pain due to the surgical procedure for breast cancer includes different neuropathic pain types such as intercostobrachial neuralgia, phantom breast pain, pain due to neuroma. Several studies however reported that the most frequent cause of pain is the damage of the intercostobrachial nerve (intercostobrachial neuralgia). Although intercostobrachial neuralgia is a relatively common condition, after breast cancer surgery, no study has investigated the clinical course of this condition at 1 year, the different neuropathic pain qualities and how this condition affects quality of life.
In this longitudinal study we aimed at seeking information on the clinical course of intercostobrachial neuralgia, the different neuropathic pain qualities, and how this condition affects quality of life.
We plan a periodic assessment (1, 3, 6 and 12 months after surgery) of patients with breast cancer surgery. Consecutive patients will be enrolled in the Department of Gynecologic Obstetrics and Urology Sciences of Sapienza University. They will undergo a detailed neurological examination. Using a structured interview, we will collect demographic, clinical data, information on sensory disturbances and pain and the DN4 questionnaire, for the diagnosis of neuropathic pain. The Neuropathic Pain Symptom Inventory will be used for dissecting the different qualities of neuropathic pain. Patients will also fulfill the quality of life questionnaire SF36. Using a thermode (ATS, PATHWAY, Medoc, Israel) we will test cold and warm detection thresholds (CDT and WDT), and cold and heat pain thresholds (CPT and HPT) in the intercostobrachial nerve territory of the affected and healthy side.
Although several studies investigated clinical characteristics and risk factors for intercostobrachial neuralgia, no study has longitudinally addressed the clinical course of this condition at 1 year, described the neuropathic pain qualities with validated querstionnaires or assessed how this condition affects quality of life.
Our longitudinal study, besides providing information on the prevalence and risk factors of intercostobrachial neuralgia, will show how sensory deficits and pain change during the one year longitudinal observation.
Using the Neuropathic Pain Symptom Inventory we will also provide information on the different neuropathic pain qualities, and with the SF36, we will show how neuropathic pain affects quality of life.
These information might improve the clinical management of intercostobrachial neuralgia in breast cancer survivors.