Abstract:

Objective

To investigate the clinical value and feasibility of reserving intercostobrachial nerve (ICBN) during modified radical mastectomy for breast cancer.

Methods

From January 2007 to January 2010, a total of 126 cases with Ⅰ-Ⅲ_A stage breast carcinoma were treated using modified radical mastectomy in our department and their data were analyzed. The intercostobrachial nerve (ICBN) was successfully reserved in 93 patients (the reserving ICBN group), and 33 patients could not reserve ICBN (the nonreserving ICBN group) because of lymphadenectasis, lymph node synechia and immobilization, and ICBN attached or invaded by tumour. The follow-up duration was 1-12 months. Comparison of dysaesthetic in chest wall and upper arm of affected side at different time (Chi-square test) and lymph node resection (t test) between the two groups was done.

Results

All patients were followed up. The mean time of operation was (125±12) min in the reserving ICBN group and (115±11) min in the non-reserving ICBN group. Lymph nodes resected was 19±3 in the reserving ICBN group and 17±2 in the non-reserving ICBN group, with no statistical difference between the two groups (P>0.050). The incidences of dysaesthetic in chest wall and upper arm of affected side at one, three and 12 months after operation were all much lower in the reserving ICBN group than in the non-reserving ICBN group (P<0.050). During the follow-up no local recurrence or distant metastasis was found in both groups.

Conclusion

Modified radical mastectomy with reserving intercostobrachial nerve for breast cancer can significantly decrease the incidence of dysaesthesia on the chest wall and upper arm of breast cancer patients after operation. The operation time can not be prolonged much and recurrent risk can not be increased using rational dissection approach.

Key words: breast neoplasms, modified radical mastectomy, intercostobrachial nerve