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Douleurs chroniques après mastectomies : aspects cliniques

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La douleur chronique post-chirurgicale

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Résumé

Les causes des douleurs de la région mammaire sont multiples, avec des causes locales (tension par oedème, lymphangite, hématome, abcès…) et des douleurs extramammaires mais rapportées au sein (syndromes myofasciculaires ; névralgies intercostales ; douleurs d’origine cardiaque, digestive, diaphragmatique ; syndromes de Tietze ou de Cyriax ; maladie de Mondor). L’examen d’une femme qui présente une douleur mammaire ne doit donc pas se résumer à un contrôle même rigoureux de la glande mammaire. L’analyse sénologique doit être intégrée à un contexte plus général comprenant au minimum une évaluation globale du morphotype, de l’état endocrinien, de la statique vertébrale et de l’équilibre psycho-affectif et socio-professionnel [1]. C’est dans un tel esprit qu’il convient d’analyser les douleurs séquellaires de la chirurgie mammaire, qui ont longtemps été négligées. L’étendue du problème a été mise en évidence en 1992 par une étude portant sur les patients des consultations de la douleur chronique en Grande-Bretagne: 20 % des patients faisaient le lien entre la chirurgie mammaire antérieure et leur douleur, et pour la moitié d’entre eux, elle en était la seule cause [2].

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Authors and Affiliations

  1. Département d’anesthésie-réanimation-douleur, Centre de traitement de la douleur chronique, Centre régional de lutte contre le cancer, Institut Bergonié, 229, cours de l’Argonne, 33076, Bordeaux Cedex, France

    F. Lakdja, L. Labrèze, F. Dixmérias, P.-O. Lakdja & M. Barrault

  2. Laboratoire de psychologie de la santé, Université Victor Segalen - Bordeaux 2, 146, rue Léo-Saignat, 33076, Bordeaux Cedex, France

    N. Rascle

Authors
  1. F. Lakdja
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  2. N. Rascle
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  3. L. Labrèze
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  4. F. Dixmérias
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  5. P.-O. Lakdja
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Correspondence to F. Lakdja .

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Lakdja, F., Rascle, N., Labrèze, L., Dixmérias, F., Lakdja, PO., Barrault, M. (2013). Douleurs chroniques après mastectomies : aspects cliniques. In: La douleur chronique post-chirurgicale. Springer, Paris. https://doi.org/10.1007/978-2-8178-0026-4_14

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  • DOI: https://doi.org/10.1007/978-2-8178-0026-4_14

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-8178-0025-7

  • Online ISBN: 978-2-8178-0026-4

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