Multimodal Management of Metastatic Brachial Plexopathy in Breast Cancer.

Abstract

Metastatic brachial plexopathy (MBP) is a severe, late complication of breast cancer marked by intractable pain, sensorimotor deficits, lymphedema, and profound functional loss. This Palliative Care Rounds report details the clinical course of a 47-year-old woman diagnosed with MBP four years after her initial breast cancer presentation, who survived a further 56 months. The case illustrates the diagnostic challenges, prolonged symptom trajectory, and complex rehabilitative and palliative needs associated with MBP in the context of extended survival. Meaningful symptom relief was achieved through the proactive integration of disease-directed therapy, pharmacologic and interventional analgesia, structured rehabilitation, and supportive care within a multidisciplinary framework. This case underscores that, despite the limited potential for neurological recovery, a coordinated, multimodal strategy initiated early can alleviate suffering, preserve function, and optimize quality of life throughout the disease course.