| Objective To investigate the effect of preserving the intercostobrachial nerve (ICBN) during modified radical mastectomy on postoperative upper limb function and quality of life in breast cancer patients. Methods A total of 74 female patients who underwent modified radical mastectomy for breast cancer at the Department of Surgical Oncology, The Second Affiliated Hospital of Bengbu Medical University, from May 2022 to February 2024 were enrolled. Based on whether the ICBN was preserved, patients were divided into an observation group (ICBN preserved) and a control group (ICBN resected), with 37 cases in each group. General data were collected, and perioperative indicators, changes in postoperative upper limb motor function and sensory abnormalities, postoperative complications, and impacts on postoperative quality of life were compared between the two groups. Results There were no statistically significant differences between the two groups in terms of age, body mass index (BMI), tumor diameter, tumor location, operative time, intraoperative blood loss, number of lymph nodes dissected, postoperative drainage tube removal time, postoperative hospital stay, or total hospitalization costs (P>0.05). 1, 3, and 6 months postoperatively, upper limb motor function on the affected side was significantly weaker than preoperative levels in both groups (P<0.05). One year postoperatively, upper limb motor function in the observation group showed no statistically significant difference compared with preoperative levels (P>0.05), while that in the control group remained significantly weaker than preoperative levels (P<0.05). The observation group demonstrated significantly better upper limb motor function on the affected side than the control group at all corresponding postoperative time points (P<0.05), and there was a significant interaction between surgical approach and time on postoperative upper limb function (P<0.05). Generalized estimating equations revealed that the incidence of sensory abnormalities decreased over time in both groups (P<0.05), and the observation group had significantly lower incidence rates than the control group at all corresponding postoperative time points (P<0.05). There was no statistically significant difference in the overall incidence of postoperative complications between the two groups (P>0.05). At different postoperative time points, the scores for each dimension of quality of life in the observation group were significantly higher than those in the control group (P<0.05), and there was a significant interaction between surgical approach and time on postoperative quality of life scores (P<0.05). Conclusion Preservation of the ICBN during modified radical mastectomy is safe and feasible, which effectively promotes the recovery of upper limb function, significantly shortens the time to recovery of social function, and improves multidimensional postoperative quality of life in patients with breast cancer. |
