Surgical Treatment of Intercostal Brachial Nerve Pain after Mastectomy and Axillary Dissection

Summary:. Postmastectomy chronic pain describes chronic pain in the anterior aspect of the thorax, axilla, and/or upper half of the arm present after surgical treatment of breast cancer and persistent for more than 3 months. The most common cause of this syndrome is damage to the intercostal brachia...

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Autores principales:	Justine S. Kim, MD, Alexander M. Spiess, MD
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer 2021
Materias:	Surgery RD1-811
Acceso en línea:	https://doaj.org/article/85f781237e164801b44df587c19355e5
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spelling	oai:doaj.org-article:85f781237e164801b44df587c19355e52021-11-25T07:58:04ZSurgical Treatment of Intercostal Brachial Nerve Pain after Mastectomy and Axillary Dissection2169-757410.1097/GOX.0000000000003935https://doaj.org/article/85f781237e164801b44df587c19355e52021-11-01T00:00:00Zhttp://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000003935https://doaj.org/toc/2169-7574Summary:. Postmastectomy chronic pain describes chronic pain in the anterior aspect of the thorax, axilla, and/or upper half of the arm present after surgical treatment of breast cancer and persistent for more than 3 months. The most common cause of this syndrome is damage to the intercostal brachial nerve. Current methods of treatment include medications, physical therapy, and peripheral nerve blocks. The literature lacks data regarding surgical interventions for intercostal brachial nerve pain in the postmastectomy and axillary dissection breast cancer patient. We discuss a case of a 47-year-old woman with left breast cancer status post-nipple-sparing mastectomy and sentinel lymph node biopsy complicated by refractory dysesthesias in the intercostal brachial nerve distribution. Axillary exploration demonstrated a surgical clip with an associated neuroma of a branch of the intercostal brachial nerve. Excision and repair resulted in immediate pain relief in the postoperative period. We propose a comprehensive treatment algorithm to address postmastectomy pain attributed to intercostal brachial nerve pathology.Justine S. Kim, MDAlexander M. Spiess, MDWolters KluwerarticleSurgeryRD1-811ENPlastic and Reconstructive Surgery, Global Open, Vol 9, Iss 11, p e3935 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Surgery RD1-811
spellingShingle	Surgery RD1-811 Justine S. Kim, MD Alexander M. Spiess, MD Surgical Treatment of Intercostal Brachial Nerve Pain after Mastectomy and Axillary Dissection
description	Summary:. Postmastectomy chronic pain describes chronic pain in the anterior aspect of the thorax, axilla, and/or upper half of the arm present after surgical treatment of breast cancer and persistent for more than 3 months. The most common cause of this syndrome is damage to the intercostal brachial nerve. Current methods of treatment include medications, physical therapy, and peripheral nerve blocks. The literature lacks data regarding surgical interventions for intercostal brachial nerve pain in the postmastectomy and axillary dissection breast cancer patient. We discuss a case of a 47-year-old woman with left breast cancer status post-nipple-sparing mastectomy and sentinel lymph node biopsy complicated by refractory dysesthesias in the intercostal brachial nerve distribution. Axillary exploration demonstrated a surgical clip with an associated neuroma of a branch of the intercostal brachial nerve. Excision and repair resulted in immediate pain relief in the postoperative period. We propose a comprehensive treatment algorithm to address postmastectomy pain attributed to intercostal brachial nerve pathology.
format	article
author	Justine S. Kim, MD Alexander M. Spiess, MD
author_facet	Justine S. Kim, MD Alexander M. Spiess, MD
author_sort	Justine S. Kim, MD
title	Surgical Treatment of Intercostal Brachial Nerve Pain after Mastectomy and Axillary Dissection
title_short	Surgical Treatment of Intercostal Brachial Nerve Pain after Mastectomy and Axillary Dissection
title_full	Surgical Treatment of Intercostal Brachial Nerve Pain after Mastectomy and Axillary Dissection
title_fullStr	Surgical Treatment of Intercostal Brachial Nerve Pain after Mastectomy and Axillary Dissection
title_full_unstemmed	Surgical Treatment of Intercostal Brachial Nerve Pain after Mastectomy and Axillary Dissection
title_sort	surgical treatment of intercostal brachial nerve pain after mastectomy and axillary dissection
publisher	Wolters Kluwer
publishDate	2021
url	https://doaj.org/article/85f781237e164801b44df587c19355e5
work_keys_str_mv	AT justineskimmd surgicaltreatmentofintercostalbrachialnervepainaftermastectomyandaxillarydissection AT alexandermspiessmd surgicaltreatmentofintercostalbrachialnervepainaftermastectomyandaxillarydissection
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Surgical Treatment of Intercostal Brachial Nerve Pain after Mastectomy and Axillary Dissection

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