skip to main content

PMPS — SCE Medical Oncology MCQ

Instant feedback + full explanation. One question, done properly.

ModerateBreast CancerPMPSSCE Medical Oncology

A 65-year-old woman with breast cancer had a mastectomy and axillary clearance. She develops chronic post-surgical pain (intercostobrachial nerve damage) affecting her chest wall and inner arm. What type of pain is this?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Neuropathic post-surgical pain (intercostobrachial neuralgia) — treated with neuropathic pain agents (amitriptyline, gabapentin/pregabalin) rather than standard analgesics

Post-mastectomy pain syndrome (PMPS) affects 20-50% of patients after breast surgery ± axillary clearance. It results from surgical damage to the intercostobrachial nerve (T2 lateral cutaneous branch) causing neuropathic pain in the chest wall, axilla and inner upper arm. Characteristics: burning, shooting, allodynia, dysaesthesia. Management: neuropathic agents (amitriptyline 10-75 mg nocte, gabapentin/pregabalin), topical capsaicin/lidocaine, TENS, and pain psychology referral. Standard analgesics (paracetamol, NSAIDs, opioids) are largely ineffective.

Reference: ESMO 2024 Pain Management; NICE NG193 Neuropathic pain; BNF