Procedural Ultrasound Location of Pectoral Nerve Neuroma Prior to Breast Reconstruction Surgery

Abstract

Chronic pain from breast surgery seems to be relatively commensurate with the increase in number of breast surgeries itself. There have been many improvements in surgery as well as anesthesia technique. These novel techniques have shown promising results in both decreasing post operative pain, opioid use along with the cascade of undesirable side effects, and even cancer recurrence. Ultrasound seems to play an integral part in the development of these analgesic techniques and furthers our understanding of relevant anatomy. We present a case where ultrasound correctly identified a chronic pain causing neuroma during the pre-procedural analgesic employment. The offending neuroma was subsequently reported to the surgeon pre procedurally, and resected under direct vision during the surgical reconstruction. This finding altered the course of the surgery and yielded positive results post operatively.