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Post-Mastectomy Pain Syndrome: An Up-to-Date Review of Treatment Outcomes

BACKGROUND: Post-mastectomy pain syndrome (PMPS) is a known debilitating surgical complication. While research on prevention, risk factors, and treatments have been conducted, there remains no cohesive treatment paradigm. The aim of our study is to synthesize the existing evidence on PMPS treatment,...

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Autores principales: Chappell, Ava G., Yuksel, Selcen, Sasson, Daniel C., Wescott, Annie B., Connor, Lauren M., Ellis, Marco F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8426165/
https://www.ncbi.nlm.nih.gov/pubmed/34522756
http://dx.doi.org/10.1016/j.jpra.2021.07.006
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author Chappell, Ava G.
Yuksel, Selcen
Sasson, Daniel C.
Wescott, Annie B.
Connor, Lauren M.
Ellis, Marco F.
author_facet Chappell, Ava G.
Yuksel, Selcen
Sasson, Daniel C.
Wescott, Annie B.
Connor, Lauren M.
Ellis, Marco F.
author_sort Chappell, Ava G.
collection PubMed
description BACKGROUND: Post-mastectomy pain syndrome (PMPS) is a known debilitating surgical complication. While research on prevention, risk factors, and treatments have been conducted, there remains no cohesive treatment paradigm. The aim of our study is to synthesize the existing evidence on PMPS treatment, which may facilitate the implementation of standardized, effective management strategies. METHODS: Using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, a comprehensive search was developed and translated for MEDLINE, Cochrane Library, EMBASE, CINAHL, PsycINFO, Web of Science, and ClinicalTrials.gov. The databases were searched using a combination of free terms, phrase searching, and database-specific controlled vocabulary related to PMPS. All unique records were by two independent reviewers. Publications on chronic (>3 months duration) pain after breast cancer-related surgery were included. Limited case series, case reports, and editorials were not included. RESULTS: A total of 3402 articles from the years 1946–2019 resulted from the literature search after deduplication. Twenty-seven articles met final inclusion criteria for analysis, which revealed 10 major treatment modalities: fat grafting, neuroma surgery, lymphedema surgery, nerve blocks and neurolysis, laser, antidepressants, neuromodulators, physical therapy, mindfulness-based cognitive therapy, and capsaicin. CONCLUSIONS: In this review, we present a comprehensive assessment of the treatments available for PMPS that may help guide breast surgeons and reconstructive surgeons to employ the most effective treatment strategies for these patients. This review supports the importance of multimodal, multidisciplinary care in improving the management of PMPS.
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spelling pubmed-84261652021-09-13 Post-Mastectomy Pain Syndrome: An Up-to-Date Review of Treatment Outcomes Chappell, Ava G. Yuksel, Selcen Sasson, Daniel C. Wescott, Annie B. Connor, Lauren M. Ellis, Marco F. JPRAS Open Review Article BACKGROUND: Post-mastectomy pain syndrome (PMPS) is a known debilitating surgical complication. While research on prevention, risk factors, and treatments have been conducted, there remains no cohesive treatment paradigm. The aim of our study is to synthesize the existing evidence on PMPS treatment, which may facilitate the implementation of standardized, effective management strategies. METHODS: Using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, a comprehensive search was developed and translated for MEDLINE, Cochrane Library, EMBASE, CINAHL, PsycINFO, Web of Science, and ClinicalTrials.gov. The databases were searched using a combination of free terms, phrase searching, and database-specific controlled vocabulary related to PMPS. All unique records were by two independent reviewers. Publications on chronic (>3 months duration) pain after breast cancer-related surgery were included. Limited case series, case reports, and editorials were not included. RESULTS: A total of 3402 articles from the years 1946–2019 resulted from the literature search after deduplication. Twenty-seven articles met final inclusion criteria for analysis, which revealed 10 major treatment modalities: fat grafting, neuroma surgery, lymphedema surgery, nerve blocks and neurolysis, laser, antidepressants, neuromodulators, physical therapy, mindfulness-based cognitive therapy, and capsaicin. CONCLUSIONS: In this review, we present a comprehensive assessment of the treatments available for PMPS that may help guide breast surgeons and reconstructive surgeons to employ the most effective treatment strategies for these patients. This review supports the importance of multimodal, multidisciplinary care in improving the management of PMPS. Elsevier 2021-08-11 /pmc/articles/PMC8426165/ /pubmed/34522756 http://dx.doi.org/10.1016/j.jpra.2021.07.006 Text en © 2021 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Review Article
Chappell, Ava G.
Yuksel, Selcen
Sasson, Daniel C.
Wescott, Annie B.
Connor, Lauren M.
Ellis, Marco F.
Post-Mastectomy Pain Syndrome: An Up-to-Date Review of Treatment Outcomes
title Post-Mastectomy Pain Syndrome: An Up-to-Date Review of Treatment Outcomes
title_full Post-Mastectomy Pain Syndrome: An Up-to-Date Review of Treatment Outcomes
title_fullStr Post-Mastectomy Pain Syndrome: An Up-to-Date Review of Treatment Outcomes
title_full_unstemmed Post-Mastectomy Pain Syndrome: An Up-to-Date Review of Treatment Outcomes
title_short Post-Mastectomy Pain Syndrome: An Up-to-Date Review of Treatment Outcomes
title_sort post-mastectomy pain syndrome: an up-to-date review of treatment outcomes
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8426165/
https://www.ncbi.nlm.nih.gov/pubmed/34522756
http://dx.doi.org/10.1016/j.jpra.2021.07.006
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