Outcome of Intercosto-brachial nerve preservation during axillary dissection in female patients with breast cancer

Yacoub, Peter; Ali, Ramadan; Baiomy, Taha

doi:10.21608/zumj.2019.14823.1338

Outcome of Intercosto-brachial nerve preservation during axillary dissection in female patients with breast cancer

Document Type : Original Article

Authors

¹ Surgical oncology department, minia oncology center, El-Minia, Egypt

² Surgical oncology unit, Department of surgery, Faculty of Medicine, Zagzig University, El-Sharkia, Egypt

10.21608/zumj.2019.14823.1338

Abstract

Background
It is assessed that more than 50 % of ladies experience pain after the treatment for breast malignancy by surgery. Neuropathic pain is the most common kind of pain. The accurate component of post mastectomy pain syndrome is obscure. During axillary evacuation Intercostobrachial nerve (ICBN) is usually yielded. Either incomplete or complete cut of the ICBN can cause sensory loss and pain. In this study we planned to improve the personal satisfaction for female patients with breast cancer by decreasing post-operative symptoms, neuralgia and preserving sensation.
Methods
Totally, 26 patients with breast cancer underwent axillary dissection. The patients were randomized between preservation (n=13) and cut (n=13) of ICBN.
Results
Early post-operative pain post-operative admission (D0, D &D2); patients in group A showed significant decrease in neuropathic pain with only 3 patients suffering from neuropathic pain . On the other hand patients in group B 10 patients suffered from neuropathic pain. Chronic post-operative pain evaluated after 3 month decreased in the two groups more in group A (preservation), only one patient still complaining from pain in group A and 7 patients in group B.
Conclusion
Intercostobrachial nerve preservation is a simple and safe procedure without much increase in operative time but greatly improving the quality of life for breast cancer female patients treated with surgery (either modified radical or conservative) including axillary evacuation though preserving sensation in the axillary skin and medial aspect of upper arm and significant decrease in post-operative acute and chronic pain.

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