Long term results of a randomised prospective study of preservation of the intercostobrachial nerve.
OBJECTIVE
We have previously reported in a randomised controlled trial comparing intercostobrachial nerve (ICBN) preservation with division that no difference in symptoms was seen between the groups at 3 months follow-up although a reduced area of sensory loss was measured on the arm. To determine if longer follow-up provides evidence for ICBN preservation, follow-up of patients in the trial at 3 years (range 32-38 months) postoperatively was performed.


METHODS
Sensory symptoms and deficits, pain, shoulder movements, arm circumference and the presence of neuromas were documented in 73 patients from the original group of 120.


RESULTS
No difference in survival or axillary recurrence was observed. The only symptom which differed between the two groups was a subjective assessment of 'different sensation' (P=0.006). No significant difference was observed in other sensory symptoms, pain, shoulder movement, arm circumference or presence of neuromas. A larger area of sensory deficit was measured in women with sacrificed nerves compared to preserved (P=0.009).


CONCLUSIONS
Preservation of the intercostobrachial nerve does not affect patient survival. It improves patient sensory deficit significantly and modestly improves long-term symptoms.
Freeman
S R M
SR
Department of Surgery, University Hospitals of South Manchester, Manchester, UK.
Washington
S J
SJ
Pritchard
T
T
Barr
L
L
Baildam
A D
AD
Bundred
N J
NJ
D000328:Adult; D001365:Axilla / Q000601:surgery; D001917:Brachial Plexus / Q000293:injuries*; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D011446:Prospective Studies; D012678:Sensation Disorders / Q000517:prevention & control; D018709:Statistics, Nonparametric; D016896:Treatment Outcome