After Susanne Hiatt’s mastectomy, she was relieved to be cancer free. Susanne was in her 60s at the time, and she had received a diagnosis both of breast cancer and non-Hodgkin's lymphoma within the same year, but survived both. She thought her troubles were behind her, but then the chronic pain came.
Susanne is a busy person — she says she’s never sitting for long. She’s very active and does a lot of yard work. She’s vivacious and warm — a true extrovert. But the pain after her single mastectomy, which she’d had on her left breast, left her depressed.
“The pain would feel like grabbing [and would] take two to three minutes to subside,” Susanne says.
Susanne couldn’t even get relief during sleep, unable to sleep on her left side. She would sometimes even sleep upright in a recliner to relieve the pain.
“After my surgery, about 2 years, I started feeling some crawling pain,” says Susanne. “I went to talk to a doctor at that time and they said there wasn’t anything we could do about that. It got so bad, over the 10 years. It restricted my arm movement — it restricted my athletic ability to do anything. I do a lot of mowing and I work in my garden. It was restricting me from doing the stuff I enjoy doing. I finally had so much pain that in March or April I went to see [my] primary care doctor. He referred me to Colton. He gave me my life back.”
Susanne went to see Colton McNichols, MD, a plastic surgeon at Liberty Hospital’s Cosmetic and Plastic Surgery Clinic. Dr. McNichols (we usually say Dr. McNichols) sees a lot of breast cancer survivors and works with them to help with some of the side effects that radiation and surgeries have on the body.
“A mastectomy can be a tradeoff for a patient — you may live with nerve pain, but you won’t have cancer,” says Dr. McNichols.
Susanne was determined to get relief from the pain caused by her radiation and mastectomy. Dr. McNichols had her point to the pain and did some preliminary tests to determine the cause of the pain.
“Radiation tends to cause a lot more scar tissue development,” he says. “I was trying to map out the origin of the pain based on some anatomical landmarks.”
Dr. McNichols tried some numbing shots on Susanne to see if he could find the source of Susanne’s pain, and when that worked, it was a good indicator that Susanne would have improvement after surgery. He says this nerve pain is common in mastectomies, as the nerves are often injured during surgery, and since Susanne also had radiation treatment, the scar tissue from that can exacerbate that pain.
Dr. McNichols’ suggestion was to perform peripheral nerve surgery. In Susanne’s case, he would remove the sensory nerves from the area where she was experiencing pain. Dr. McNichols performed multiple peripheral nerve procedures in his residency at Johns Hopkins, but the application for breast cancer patients was new.
When Dr. McNichols first suggested the nerve surgery to Susanne, he wasn’t sure if this particular surgery had ever been performed following a mastectomy. However, in the weeks between scheduling the surgery and actually performing it, a research paper was published from the University of Michigan supporting that it had been successful in this exact use.
“For me, it was the first time I had actually read about someone else doing this,” says Dr. McNichols. “It encouraged me to know that others had been successful. It’s not something I invented, but I would say it is novel to the Kansas City area.”
And Dr. McNichols was right — the surgery worked and Susanne’s pain has been gone ever since.
“May 16th, I’ll never forget that day,” she says. When talking about the surgery, she frequently raises her arms up in victory, showing off her range of motion and lack of pain.
“I’m just so thankful, really, that I have my life back,” says Susanne, now 76. “I was so restricted in the pain. But now I have no restrictions whatsoever. I can do anything I did whenever I was 40 years old and I have the energy to do it. And my mindset, I was becoming depressed because I couldn’t do anything. My mindset [now] is, I’m back to 40.
Dr. McNichols is thankful that he was able to help his patient and is excited about the possibilities moving forward in applying this surgery to more patients with pain following breast cancer.
“It’s very rewarding to know that you’re able to essentially give somebody's life back after having gone through years of pain and cancer diagnosis,” says Dr. McNichols.