Management of acute pain, especially post-operative pain, in patients on high dose opioids is a challenge that requires in-depth knowledge of pharmacokinetics and the formulation of a careful management plan to avoid withdrawal symptoms and inadequate pain management. • Chronic pain after cancer surgery may occur in up to 50% of patients. Risk factors for the development of chronic pain after breast cancer surgery include: young age, chemo and radiotherapy, poor post-operative pain control and certain surgical factors. Radiotherapy induced neuropathic pain has become less prevalent, but can cause long-standing pain and disability. • Patient education is an effective strategy.
