Breast neuropathy is a condition involving nerve-related pain or other abnormal sensations in the breast, armpit, or chest wall. These feelings originate from nerve irritation or damage, not from an issue within the breast tissue itself. This condition arises when nerves that provide sensation to the chest area are affected, leading to a range of uncomfortable symptoms.
Symptoms of Breast Neuropathy
The sensations associated with breast neuropathy vary between individuals and may be constant or intermittent. A common complaint is a persistent burning pain, while others experience sharp, stabbing, or electric shock-like pains that come and go.
Another frequent symptom is a tingling sensation, often described as “pins and needles,” or a complete loss of feeling in parts of the breast or surrounding area. In some cases, the skin can become extremely sensitive to touch, a condition known as allodynia. With allodynia, stimuli that are not normally painful, such as the light pressure from clothing or a bedsheet, can cause significant pain.
The intensity of these symptoms can range from mild to severe. Some individuals may feel a deep, dull ache in the chest wall or armpit region. The area might feel tender, and movements of the arm or shoulder could worsen the discomfort. Tracking the location, type, and intensity of these sensations can provide valuable information for a healthcare provider.
Common Causes and Risk Factors
The most frequent cause of breast neuropathy is nerve injury during breast-related surgeries. Procedures such as mastectomy, lumpectomy, breast reconstruction, or augmentation can lead to the stretching, compression, or severing of nerves in the chest wall. This is particularly common with the intercostal nerves, which run between the ribs and provide sensation to the chest and upper arm. When this occurs after a mastectomy, it is often called post-mastectomy pain syndrome (PMPS).
During surgery, especially when lymph nodes are removed from the armpit (axillary lymph node dissection), the intercostobrachial nerve is at high risk of injury. Damage to this nerve can cause pain, numbness, or altered sensation along the inner and back part of the upper arm. The formation of a neuroma, a disorganized growth of nerve tissue at the site of an injury, can also be a source of persistent, localized pain.
Radiation therapy, a common cancer treatment, can cause fibrosis, which is the scarring and thickening of tissues, potentially leading to nerve entrapment and chronic pain. Direct trauma or injury to the chest area can also damage these sensitive nerves. Less commonly, infections that affect nerve pathways, such as shingles (herpes zoster) appearing on the chest, can result in lasting nerve pain in the breast region.
The Diagnostic Process
Diagnosing breast neuropathy begins with a discussion of your symptoms and medical history, including any previous surgeries, injuries, or medical conditions. The diagnosis is often clinical, meaning it is based heavily on the patient’s description of the pain, such as its burning or stabbing nature, and its specific location.
During a physical examination, the doctor will assess the area for sensitivity to touch and temperature. They may use light touch or a pinprick to map out areas of numbness or heightened sensitivity. Tapping gently over the suspected injured nerve, a test known as the Tinel sign, may reproduce the pain, which can help confirm the diagnosis of a neuroma.
Imaging tests like an ultrasound or MRI are not used to visualize the nerve damage directly but are important for ruling out other possible causes of breast pain, such as cysts, abscesses, or a recurrence of cancer. In some cases, a diagnostic nerve block, where a local anesthetic is injected to numb the suspected nerve, may be used to confirm the source of the pain.
Management and Treatment Options
Management of breast neuropathy focuses on controlling symptoms and improving quality of life. Treatment often starts with conservative approaches, including wearing soft, loose-fitting clothing and using topical treatments. Lidocaine patches or creams applied to the painful area can provide localized numbing and relief. Another topical option is capsaicin cream, derived from chili peppers, which can desensitize nerve endings over time.
When topical treatments are not sufficient, healthcare providers may prescribe oral medications specifically designed for nerve pain. These are different from standard pain relievers like ibuprofen. Medications such as gabapentin or pregabalin, which are anticonvulsants, can help calm overactive nerve signals. Certain types of antidepressants, including duloxetine or amitriptyline, are also effective at managing neuropathic pain by influencing chemical messengers in the brain.
Physical therapy can be beneficial for persistent pain, with targeted exercises to gently stretch the chest muscles and improve shoulder mobility. Nerve block injections, which deliver anesthetic and sometimes a steroid directly to the affected nerve, can provide temporary but significant relief. Some individuals also find relief through complementary therapies such as acupuncture.