How do you explain fleeting, post-RT breast pain to patients, and what do you recommend as management?
It is common, underreported, and appears to be nerve related. I recommend assurance as intensity and frequency improve with time.
It is very common for patients to describe "zingers" during radiotherapy. Here is my experience: as others mentioned, with questioning, for many women, shooting, fleeting pain appears post operatively (before RT) and seems nerve related. Often, the pain is improving before radiation (less frequent, ...
Fleeting shooting electricity-like pains are not uncommon after breast preservation surgery in our patients.
I explain to patients that these symptoms are self-limited and usually resolve over a few months. Over-the-counter ibuprofen for three days is often an effective treatment.
A prospective study...
I tell them the "zingers" are common and my theory is that they are the nerves healing after surgery. They decrease in intensity and frequency over time but can actually last years, but do not reflect anything sinister. More interesting to me, since I've treated breast patients for decades, is that ...
Like Dr. @Dr. First Last, I'm a big proponent of stretching, but my names for these maneuvers aren't quite so classy.
"You have the right to remain silent": fingertips behind the head (or ears) & gently bring the elbows back.
"Mick Jagger": back of hands against the small of the back (or just hands ...
I agree that this is expressed by breast patients more often than we like to admit. I think it is important to distinguish between "breast pain" which is less common in my experience from chest wall pain. Often, if I gently examine the affected breast they have no complaints until I start to press d...
I explain that the fleeting pains are related to evolving scar tissue and that they typically decrease in intensity and frequency as the scar tissue matures.
The value of reassurance should not be underestimated. I let my patients know that “zingers” are nearly universal and rarely require pain medication. They are benign and decrease in intensity and frequency with time.
Anecdotally, engorgement of the breast during lactation produces a similar feeling...
We noticed this many years ago and I named it "spontaneous breast pain" after eliminating other identifiable reasons for that discomfort.
After the patient reports it I say, "so this pain you have in the treated breast comes on you unexpectedly. It can wake you up in the middle of the night for no o...
Patients typically have more pain at the sentinel lymph node site than lumpectomy site (80+% of my patients), likely from needing to "dig down" and cut those superficial cutaneous nerves to get to the sentinel node. Many patients state the biopsy of the breast mass was more painful than the actual l...