The present study aimed to determine the incidence and magnitude of acute and chronic pain after partial or complete mastectomy and reconstructive breast surgery. Medical records were reviewed from 174 randomly sampled female patients undergoing partial (n=79) or complete mastectomy (n=46) or reconstructive breast surgery after mastectomy (n=49) between 1/1/03 and 12/31/05. The data that were collected included demographics, radiation/chemotherapy, and pre- and post-operative pain scores (0-10 scale). Frequencies of events and mean + SEM values were calculated. Pre-operative pain scores were very low (0.52 + 0.21 for partial mastectomy, 1.27 + 0.43 for complete mastectomy and 0.05 + 0.05 for reconstructive surgery patients). Post-operative pain scores taken within two weeks of surgery were higher than pre-operative pain scores, but generally low (2.36 + 0.56 for partial mastectomy, 1.21 + 0.39 for complete mastectomy and 2.20 + 0.96 for reconstruction). Post-operative pain scores taken 6-12 months after surgery were lower than those taken within two weeks of surgery (0.69 + 0.34 for partial mastectomy, 0.29 + 0.29 for complete mastectomy and 1.18 + 0.55 for reconstruction). While mean post-operative pain scores were low, more women experienced severe pain (defined as a pain score of >5) after surgery than before. Pre-operative pain scores qualified as severe in 2.6% of partial mastectomy, 4.4% of complete mastectomy, and 0.0% of reconstructive surgery patients. Two weeks post-operatively, severe pain was reported by 27.3% of partial mastectomy, 5.3% of complete mastectomy, and 20.0% of reconstructive surgery patients. Six to twelve months after surgery, severe pain was reported by 6.2% of partial mastectomy, 0.0% of complete mastectomy, and 11.8% of reconstructive surgery patients. These results suggest that while post-surgical pain is not problematic for the majority of breast surgery patients, a subset of women will experience severe post-operative pain.