Ricerc@Sapienza

Intercostobrachial neuropathy, often resulting in neuropathic pain, is a common complication of breast cancer surgery. In
this 1-year longitudinal study, we aimed at seeking information on the frequency, clinical features, and course of painless
and painful intercostobrachial neuropathy. We enrolled 40 women previously undergoing breast cancer surgery. In these
patients, we collected, at 3, 6 and 12 months after surgery, clinical and quantitative sensory testing (QST) variables to
diagnose intercostobrachial neuropathy, DN4 questionnaire to identify neuropathic pain, Neuropathic Pain Symptom
Inventory to assess the different neuropathic pain symptoms, the Beck Depression Inventory to assess depressive
symptoms, and SF36 to assess quality of life and Patient Global Impression of Change. Clinical and QST examination
showed an intercostobrachial neuropathy in 23 patients (57.5%). Out of the 23 patients, five experienced neuropathic
pain, as assessed with clinical examination and DN4. Axillary surgery clearance was associated with an increased risk of
intercostobrachial neuropathy. Whereas sensory disturbances improved during the 1-year observation, neuropathic pain
did not. Nevertheless, Beck Depression Inventory, SF36, and the Patient Global Impression of Change scores significantly
improved over time. Our study shows that although intercostobrachial neuropathy is a common complication of
breast cancer surgery, neuropathic pain affects only a minor proportion of patients. After 1 year, sensory disturbances
partially improve and have only a mild impact on mood and quality of life.