Breast-cancer associated brachial plexopathy - still a diagnostic and treatment challenge

Brachial plexopathy (BP) in breast cancer patients is a rare event, attributed mainly to radiation damage or tumor infiltration of the plexus. Differentiation between these etiologies is a diagnostic challenge. We have studied retrospectively eight female patients with breast cancer who developed a clinical syndrome of brachial plexopathy following the treatment of the primary disease, out of more than 900 during the last 10 years. None of the available ancillary tests such as plain films, CT or MRI studies, EMG or tumor markers, provided reliable data regarding the cause of the plexopathy. Biopsy, on the other hand, was not always feasible. In our series, all the patients who developed BP did not have any blood-borne metastases before developing the syndrome. In 3 of the patients BP was the first sign of recurrence. In the other 5, only local or locoregional relapse preceded. In 7 of the 8 patients the left side was affected. Treatment should be tailored in each case according to course of the disease. The optimal treatment has not yet been defined.