Complex Postmastectomy Chest Wall Pain Treated with Targeted Regional Anesthesia

<jats:title>Abstract</jats:title> <jats:p>A 52-year-old woman presents with persistent neuropathic pain affecting the left chest wall and upper arm 4 months following a left-sided mastectomy with axillary lymph node dissection for invasive ductal carcinoma. The pain is described as burning and stabbing in quality, rated 7/10 in severity, and accompanied by intermittent tingling, numbness, and allodynia. Symptoms are exacerbated by movement and have been refractory to pharmacologic therapies, including gabapentin and serotonin–noradrenaline reuptake inhibitors. The pain has significantly disrupted sleep, limited daily activities, and contributed to emotional distress and anxiety regarding cancer recurrence. This case underscores the diagnostic complexity and therapeutic challenges of postmastectomy pain syndrome, a frequently underrecognized chronic neuropathic condition in breast cancer survivors.</jats:p>