Objective: To determine the feasibility of preservation of intercostobrachial nerve (ICBN) in breast cancer.
Methods: During June 2004 to June 2006, 99 patients with operable breast cancer receiving an axillary lymph node dissection at our department were analyzed. The extirpated ICBN and ambient tissues were tested by HE staining to observe the pathological changes.
Results: In 96 (96.97%) cases with ICBN sacrificing, the nerves were not violated microscopically and the nerve cells remained intact. Of 28 patients with axillary lymphadenectasis, only 3 cases (10.71%) were found to have tumor emboli in the peri-neural vessels.
Conclusion: The preservation of ICBN is a feasible and safe technique. The operative approach should be advocated. If at all possible, a surgeon should identify ICBN and preserve it.
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Reg Anesth Pain Med
December 2024
Department of Anesthesia and Perioperative Medicine, University of Western Ontario, London, Ontario, Canada
Background: Innervation of the breast includes branches of thoracic intercostal nerves, the superficial cervical plexus, the brachial plexus, and the intercostobrachial nerve (ICBN). Commonly used blocks for breast surgery provide incomplete analgesia of the axillary region. This cadaveric study aims to identify and map the axillary sensory cutaneous nerves.
View Article and Find Full Text PDFInt J Surg Case Rep
December 2024
Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy; Breast Unit, University of Naples Federico II, Naples, Italy.
Introduction And Importance: Iatrogenic nerve injury is a possible complication of axillary lymph node dissection (ALND), which remains standard-of-care for some breast cancer patients. Recently, several studies have demonstrated that nerves auto-fluoresce in near-ultraviolet light (NUVL). We describe three women with BC in whom a recently-developed NUVL camera was used to facilitate visualization of and prevent iatrogenic injury to the intercostobrachial, long thoracic, and thoracodorsal nerves during ALND.
View Article and Find Full Text PDFJ Clin Ultrasound
November 2024
Department of Rehabilitation Medicine, Neuromusculoskeletal Institute, Rowan-Virtua School of Osteopathic Medicine, Sewell, New Jersey, USA.
A 40-year-old woman presented with chronic left anterior shoulder, upper arm, and axillary pain following a routine mammogram 3 years prior. Despite multiple interventions, her pain persisted significantly affecting her quality of life. Ultrasound examination revealed fascicular edema in the medial brachial cutaneous nerve (MBCN), intercostobrachial cutaneous nerve (ICBN), and a positive sono-Tinel.
View Article and Find Full Text PDFReg Anesth Pain Med
October 2024
Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Backgrounds: Ultrasound-guided proximal and distal approaches of the intercostobrachial nerve (ICBN) blocks facilitate analgesia for upper arm and axillary surgery, though success rates vary and lack clinical comparison. This study compared their anesthetic and analgesic efficacy as an adjunct to the supraclavicular brachial plexus block for upper arm arteriovenous access surgery.
Methods: 60 end-stage renal disease patients undergoing upper arm arteriovenous access were randomly assigned to receive either proximal or distal ICBN block using 10 mL of a mixture of levobupivacaine and lidocaine with epinephrine.
Breast Cancer
September 2024
Department of Physiology, All India Institute of Medical Sciences (AIIMS), New Delhi, 110029, India.
Background: Post-mastectomy pain Syndrome (PMPS), characterized by chronic neuropathic pain stemming from intercostobrachial nerve lesions, presents a formidable clinical challenge. With the incidence of breast cancer surging, effective interventions for PMPS are urgently needed. To address this, we conducted this double-blind, placebo-controlled, randomized clinical trial to study the efficacy of repetitive Transcranial Magnetic Stimulation (rTMS) therapy over the motor cortex on pain, quality of life and thermal sensitivity in PMPS patients.
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