Document Detail


Preservation versus section of intercostal-brachial nerve (IBN) in axillary dissection for breast cancer--a prospective randomized trial.
MedLine Citation:
PMID:  9630850     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Preservation of the intercostal-brachial nerve is advocated to reduce side effects of axillary dissection for breast cancer. We conducted a prospective randomized trail to compare functional results: sensory deficit and/or shoulder pain in preserved (group I) vs sacrificed (group II) intercostal-brachial nerve (IBN). METHODS: From July 1993 to April 1994, 128 patients presenting with an invasive operable breast cancer were operated on by mastectomy n = 28 or lumpectomy n = 100 and axillary dissection. The patients were eligible for randomization when the IBN was preserved at the end of the axillary dissection. Group I (nerve preservation) included 66 patients and group II (nerve section) 62 patients. RESULTS: The two groups were well balanced for TNM, type of surgery, number of nodes dissected and positive, post-operative adjuvant treatment. Examinations were conducted at 3, 6 and 12 months after surgery. Sensory deficit in the IBN area was reported by one patient in group I and four patients in group II, at 3 months (P = 0.36, NS). No patients, apart from one in group II, reported functional trouble at 18 months. Major shoulder motion, limitation and pain developed in four patients in group I and three in group II (NS). This was attributed to depression and treated adequately. Analysis of sensory deficit was impossible in these patients. CONCLUSIONS: Conservation of the IBN, while anatomically preferable, is not functionally necessary during axillary dissection for breast cancer.
Authors:
R J Salmon; Y Ansquer; B Asselain
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology     Volume:  24     ISSN:  0748-7983     ISO Abbreviation:  Eur J Surg Oncol     Publication Date:  1998 Jun 
Date Detail:
Created Date:  1998-07-09     Completed Date:  1998-07-09     Revised Date:  2007-07-02    
Medline Journal Info:
Nlm Unique ID:  8504356     Medline TA:  Eur J Surg Oncol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  158-61     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Axilla / surgery
Brachial Plexus / surgery*
Breast Neoplasms / surgery*
Female
Humans
Intercostal Nerves / surgery*
Mastectomy / adverse effects,  methods*
Middle Aged
Pain, Postoperative / etiology
Prospective Studies
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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