Long term results of a randomised prospective study of preservation of the intercostobrachial nerve

Eur J Surg Oncol. 2003 Apr;29(3):213-5. doi: 10.1053/ejso.2002.1409.

Abstract

Aim: We have previously reported in a randomised controlled trial comparing intercostobrachial nerve (ICBN) preservation with division that no difference in symptoms was seen between the groups at 3 months follow-up although a reduced area of sensory loss was measured on the arm. To determine if longer follow-up provides evidence for ICBN preservation, follow-up of patients in the trial at 3 years (range 32-38 months) postoperatively was performed.

Methods: Sensory symptoms and deficits, pain, shoulder movements, arm circumference and the presence of neuromas were documented in 73 patients from the original group of 120.

Results: No difference in survival or axillary recurrence was observed. The only symptom which differed between the two groups was a subjective assessment of 'different sensation' (P=0.006). No significant difference was observed in other sensory symptoms, pain, shoulder movement, arm circumference or presence of neuromas. A larger area of sensory deficit was measured in women with sacrificed nerves compared to preserved (P=0.009).

Conclusion: Preservation of the intercostobrachial nerve does not affect patient survival. It improves patient sensory deficit significantly and modestly improves long-term symptoms.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Axilla / surgery
  • Brachial Plexus / injuries*
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery*
  • Chi-Square Distribution
  • Female
  • Humans
  • Longitudinal Studies
  • Lymph Node Excision / methods*
  • Lymphatic Metastasis
  • Prospective Studies
  • Sensation Disorders / prevention & control
  • Statistics, Nonparametric
  • Treatment Outcome