Curative Effect Analysis Of Preserving Intercostobrachial Nerve In Modified Radical Mastectomy

Research objective:To investigate the clinical value of reserving intercostobrachial nerve during modified radical mastectomy on I, II breast cancer patient compared removing ICBN with reserving ICBN.Clinical materials and methods:From January 2004 to December 2008,113 cases with I-III stage breast cancer patients modified radical mastectomy in our hospital who adjuvant radiotherapy, chemotherapy and endocrine therapy. According to whether removing ICBN the patients were divided into two groups:one was retain ICBN as ICBN group, other was unretain the ICBN as control group. After two groups of the patients were followed up 8 to 24 months, two groups of patients on the ipsilateral upper arm, armpits and other parts of the skin of sensory impairment and recovery status, local recurrence, distant metastasis, were compared.Results:(1) 1 week after surgery, patients feel ipsilateral upper arm and armpit conduct inquiries:ICBN group,83.12%(64/77) of patients with ipsilateral upper arm and armpit consciously feel better than 27.78%(10/36) of patients in control group, there were no discomfort in ICBN group, but 72.22%(26/36) of patients with ipsilateral upper arm and armpit numbness, abnormal sensation of pain and other conditions (P<0.05). And ICBN group,92.31%of patients (12/13) feel ipsilateral upper arm and underarm paresthesia would recovery in the short term (3 months).But in control group, patients with abnormal short-term sensory recovery was only 38.46%.(2) 1 week after surgery, the patient were tested on upper arm and axillary skin using a sterile needle.In ICBN group,31.17%(24/77) of patients felt But in control group, only 80.56%of the patients feel differences in the affected side and healthy side(P <0.05).(3) Two groups were followed up for 8 to 24 months, in all cases of ICBN group were no local recurrence and distant metastasis, survival rate was 100%. Recurrence rate, recently survival rates and metastasis rate in two group showed no significant difference.Conclusion:It is feasible to retain ICBN in the early breast cancer patients modified radical mastectomy in breast cancer axillary lymph node dissection. Because it keeps the affected side of the skin of the inside and ipsilateral upper arm and other parts of the sensory function, significantly reducing the incidence of abnormal skin sensation in upper arm after the surgery, improved quality of life of patients, but also does not increase the risk of local recurrence, so it has a high clinical value.