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Variations in sensitivity after sectioning the intercostobrachial nerve.

J P Paredes1, J L Puente, J Potel

  • 1Department of Surgery, Hospital General de Galicia, Universidad de Santiago de Compostela, La Coruña, Spain.

American Journal of Surgery
|November 1, 1990
PubMed
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Sectioning the intercostobrachial nerve during modified radical mastectomy causes significant armpit and arm anesthesia. Preserving this nerve, especially when lymph nodes are clear, is recommended to maintain sensation.

Area of Science:

  • Surgical Oncology
  • Neuroscience
  • Clinical Anatomy

Background:

  • Modified radical mastectomy (MRM) is a common breast cancer surgery.
  • The intercostobrachial nerve (ICN) is frequently sectioned during MRM.
  • Sectioning the ICN can lead to sensory deficits in the axilla and arm.

Purpose of the Study:

  • To prospectively evaluate sensory changes in the axilla and arm following ICN sectioning during MRM.
  • To compare sensory outcomes between patients with intact ICN, sectioned ICN, and sectioned peripheral branches.
  • To determine the impact of ICN status on postoperative sensitivity to touch and pain.

Main Methods:

  • Prospective study of 208 patients undergoing MRM between 1978 and 1987.
  • Patients categorized into three groups: ICN sectioned (n=139), ICN intact (n=30), and peripheral ICN branches sectioned (n=39).

Related Experiment Videos

  • Regular postoperative examinations assessed sensitivity to touch and pain in the axilla and arm; 433 examinations were performed.

    • Main Results:

    • Sectioning the ICN led to progressive anesthesia in the armpit and hypoesthesia on the inner arm.
    • Patients with an intact ICN experienced less intense and shorter-lasting sensory alterations.
    • Statistically significant differences in sensory outcomes were observed between the groups.

    Conclusions:

    • ICN sectioning during MRM results in predictable sensory deficits.
    • Preservation of the ICN is advised when axillary lymph nodes are not infiltrated by tumor.
    • Maintaining ICN integrity can improve postoperative quality of life by preserving sensation.