ABSTRACT
Axillary clearance has been an integral part of breast cancer surgery. However, it can present sequela and complications including: limitation of shoulder movement, paresthesia and chronic pain in the arm and axilla, which are related to the nerve injuries. This study aimed at evaluating the feasibility of preservation of Intercostobrachial nerve [ICBN] during complete axillary dissection and to compare the impact of preservation or sacrifiction on postoperative axillary and inner aspect of the arm symptoms and sensation. The study was carried out on 58 consecutive patients with operable carcinoma of the breast, admitted to Alexandria Surgical Oncology Unit during 2003. Preservation of ICBN during complete axillary dissection was attempted in all patients. Accordingly they are divided into: thirty patients in whome the ICBN was preserved [Group A] and 28 patients, in whome the ICBN was sacrificed [Group B]. Clinical examination of the patients revealed that 34 cases were N[0] [58.6%]: 18 in group A and 16 cases in group B. During surgery, the nerve was found to be easily preserved in slim patients and when the axillary lymph nodes were not heavily involved. After 3 and 6 months; improvement of sensory symptoms was found both subjectively and objectively in group A. This was significantly noticed after 3 months postoperative. On the other hand persistence of anesthesia and hyposthesia was manifested in group B patients. Although patients who had preservation of ICBN were symptomatic in the immediate postoperative period, yet resumption of normal axillary and inner arm sensation was attained with longer follow up. It is recommended to preserve the ICBN wherever feasible as it has a positive impact on maintaining the axillary and inner arm sensation with a subsequent improvement in the quality of life in these patients