1. 2025;28;545-550The Assessment of Neuropathic Pain in Patients with Lymphedema Secondary to Breast Cancer
   Cross-Sectional Study
   Mert Sancar, MD, and Ekim Can Ozturk, MD.

BACKGROUND: Lymphedema is a chronic, progressive condition characterized by excessive fluid retention due to impaired lymphatic drainage. While neuropathic pain is known to affect a significant proportion of chronic pain sufferers, the frequency of neuropathic pain in patients with breast cancer–associated secondary lymphedema remains unclear. This study investigates the prevalence and characteristics of neuropathic pain in women with secondary lymphedema caused by breast cancer treatments.

OBJECTIVE: To determine the prevalence of neuropathic pain in female patients diagnosed with breast cancer–associated secondary lymphedema and to explore that pain’s association with lymphedema severity.

STUDY DESIGN: A cross-sectional study.

SETTING: A tertiary hospital physical medicine and rehabilitation center.

METHODS: This cross-sectional study included 100 women aged 18 to 65 diagnosed with secondary lymphedema related to breast cancer. Neuropathic pain was assessed using the Self-reported Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) and Douleur Neuropathique 4 (DN-4) questionnaires. Lymphedema was staged according to the International Society of Lymphology classification. Data on pain levels and quality of life were collected using the Numeric Rating Scale (NRS-11) and the Lymphedema Life Impact Scale (LLIS).

RESULTS: Neuropathic pain was identified in 14% of patients through the DN-4 and 17% through the S-LANSS. A significant correlation was found between higher lymphedema grades and increased neuropathic pain scores (P < 0.001). Patients with Grade 3 lymphedema reported significantly higher pain levels than did those with lower grades.

LIMITATIONS: Cross-sectional nature of the study and the single-center design.

CONCLUSION: Neuropathic pain is prevalent in patients with breast cancer–associated secondary lymphedema, especially in more advanced cases of cancer. Early identification and targeted pain management strategies are crucial to improving the quality of life for these patients.

KEY WORDS: Breast cancer, neuropathic pain, prevalence, quality of life, secondary lymphedema