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01-03-2014 | Original Article

Impact of preservation of the intercostobrachial nerve during axillary dissection on sensory change and health-related quality of life 2 years after breast cancer surgery

Authors: Naruto Taira, Kojiro Shimozuma, Shozo Ohsumi, Katsumasa Kuroi, Takeru Shiroiwa, Takanori Watanabe, Mitsue Saito

Published in: Breast Cancer | Issue 2/2014

Abstract

Background

Sensory loss or paresthesia due to division of the intercostobrachial nerve (ICBN) is a complication of axillary lymph node dissection (ALND). Preservation of the ICBN may be of value, but few prospective studies have shown an impact of preservation on sensory changes or health-related quality of life (HRQOL) after breast cancer surgery.

Methods

This prospective study was performed to evaluate the association between ICBN preservation and sensory change and HRQOL at 1 (baseline), 6, 12, and 24 months after breast cancer surgery in 140 patients. The sensory examination included dysesthesia, paresthesia, and abnormal touch and pain sensation in the upper arm.

Results

Division of the ICBN did not influence the frequency or severity of subjective dysesthesia and paresthesia. There was no marked difference in touch or pain sensation at baseline between patients with a preserved (group P) and divided (group D) ICBN. In group P, the percentage of patients aware of a sensory deficit or loss decreased with time, and that of patients aware of a hypersensitive sensation increased. These changes did not occur in group D, leading to a significant difference between the groups at 24 months. The main difference between the groups was the area with reduced touch or pain sensation. This area decreased with time in group P, but not in group D. ICBN preservation or division did not influence HRQOL.

Conclusion

ICBN preservation in ALND has a benefit of a reduced area with long-term axillary hypoesthesia, but has no influence on improvement of pain and HRQOL.

Lyman GH, Giuliano AE, Somerfield MR, Benson AB 3rd, Bodurka DC, Burstein HJ, et al. American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer. J Clin Oncol. 2005;23:7703–20.PubMedCrossRef

Giuliano AE, Hunt KK, Ballman KV, Beitsch PD, Whitworth PW, Blumencranz PW, et al. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA. 2011;305:569–75.PubMedCrossRef

Kwan W, Jackson J, Weir LM, Dingee C, McGregor G, Olivotto IA. Chronic arm morbidity after curative breast cancer treatment: prevalence and impact on quality of life. J Clin Oncol. 2002;20:4242–8.PubMedCrossRef

Assa J. The intercostobrachial nerve in radical mastectomy. J Surg Oncol. 1974;6:123–6.PubMedCrossRef

Teicher I, Poulard B, Wise L. Preservation of the intercostobrachial nerve during axillary dissection for carcinoma of the breast. Surg Gynecol Obstet. 1982;155:891–2.PubMed

Temple WJ, Ketcham AS. Preservation of the intercostobrachial nerve during axillary dissection for breast cancer. Am J Surg. 1985;150:585–8.PubMedCrossRef

Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, et al. The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol. 1993;11:570–9.PubMed

Brady MJ, Cella DF, Mo F, Bonomi AE, Tulsky DS, Lloyd SR, et al. Reliability and validity of the Functional Assessment of Cancer Therapy-Breast quality-of-life instrument. J Clin Oncol. 1997;15:974–86.PubMed

Fumimoto H, Kobayashi K, Chang CH, Eremenco S, Fujiki Y, Uemura S, et al. Cross-cultural validation of an international questionnaire, the General Measure of the Functional Assessment of Cancer Therapy scale (FACT-G), for Japanese. Qual Life Res. 2001;10:701–9.PubMedCrossRef

10.

Shimozuma K, Ohashi Y, Yoshimura K, Iha S, Saeki H, Kuroi K, et al. Reliability and validity of the Japanese version of the Functional Assessment of Cancer Therapy-Breast (FACT-B) quality-of-life instrument; Women’s Health Outcome Study (WHOS)—01. Qual Life Res. 2000;9:287.

11.

Japan Medical Association Research Institute. Development and clinical application of QOL measurement instruments for cancer patients (I)—making Japanese versions of QOL questionnaires developed in North American or European countries and validation of reliability and validity of FACT-B, a QOL questionnaire for breast cancer patients; 2001 (in Japanese). http://www.jmari.med.or.jp/research/research.php?type=&mode=1&cno=&author=%B2%BC%BA%CA%B9%B8%C6%F3%CF%BA. Accessed October 17, 2011.

12.

Loukas M, Hullett J, Louis RG Jr, Holdman S, Holdman D. The gross anatomy of the extrathoracic course of the intercostobrachial nerve. Clin Anat. 2006;19:106–11.PubMedCrossRef

13.

Abdullah TI, Iddon J, Barr L, Baildam AD, Bundred NJ. Prospective randomized controlled trial of preservation of the intercostobrachial nerve during axillary node clearance for breast cancer. Br J Surg. 1998;85:1443–5.PubMedCrossRef

14.

Freeman SR, Washington SJ, Pritchard T, Barr L, Baildam AD, Bundred NJ. Long term results of a randomised prospective study of preservation of the intercostobrachial nerve. Eur J Surg Oncol. 2003;29:213–5.PubMedCrossRef

15.

Torresan RZ, Cabello C, Conde DM, Brenelli HB. Impact of the preservation of the intercostobrachial nerve in axillary lymphadenectomy due to breast cancer. Breast J. 2003;9:389–92.PubMedCrossRef

16.

Mansel RE, Fallowfield L, Kissin M, Goyal A, Newcombe RG, Dixon JM, et al. Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: the ALMANAC Trial. J Natl Cancer Inst. 2006;98:599–609.PubMedCrossRef

Title: Impact of preservation of the intercostobrachial nerve during axillary dissection on sensory change and health-related quality of life 2 years after breast cancer surgery
Authors: Naruto Taira
Kojiro Shimozuma
Shozo Ohsumi
Katsumasa Kuroi
Takeru Shiroiwa
Takanori Watanabe
Mitsue Saito
Publication date: 01-03-2014
Publisher: Springer Japan
Published in: Breast Cancer / Issue 2/2014
Print ISSN: 1340-6868
Electronic ISSN: 1880-4233
DOI: https://doi.org/10.1007/s12282-012-0374-x

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