Preservation of the Intercostobrachial Nerve during Axillary Dissection for Breast Cancer at the Surgical Oncology Unit of Cancer Department of Dakar University

Abstract

The intercostobrachial nerve (ICBN) is responsible for the sensory innervation of a part of the inner side of the arm. Injury of the intercostobrachial nerve is a complication of axillary dissection during lymph node dissection. Objective: This study aimed to determine the effect of preservation of the intercostobrachial nerve on postoperative sensory disturbances. Methods: This is a prospective, single-center study which was carried out in 90 patients followed in the oncology department of the Aristide Le Dantec hospital in Dakar, suffering from breast cancer and having undergone breast surgery associated with axillary dissection, for a period of 6 months. The patients were divided into two groups depending on whether the intercostobrachial nerve (ICBN) was preserved or not. The two groups were compared in terms of the incidence of sensory disturbances. Results: Sixty patients without nerve preservation and 30 patients with nerve preservation were included in the study, i.e., 90 patients in total. ICBN was injured in 60 patients of which 41 patients (83.7%) developed numbness in the inner arm. While in the preserved group, only 8 patients suffered from numbness (16.3%) with a significant P value of 0.002; however, for other variables such as the incidence of neuropathic pain and hypoesthesia-like sensory deficit, there was no significant difference. Conclusion: Preservation of the intercostobrachial nerve during axillary dissection for breast cancer reduces the incidence of sensory disturbances on the upper limb.