Our Summary

This study investigated the effects of two different surgical methods and the use of radiotherapy (RT) on the health of the lateral pectoral nerve (LPN) in patients who had a specific type of breast cancer surgery. The two methods were a nerve-sparing technique (LPNST) and a standard surgery. The health of the LPN was assessed using electromyography (EMG), a diagnostic procedure to assess the health of muscles and the nerve cells that control them.

The study included 66 patients who were divided into groups based on the type of surgery they had and whether they received radiotherapy.

The study found that the nerve-sparing technique was better at preserving the health and function of the LPN, as shown by better EMG values (lower latency and higher amplitude). Radiotherapy was found to cause nerve damage in both groups, but the nerve-sparing technique still showed better results even with the inclusion of radiotherapy.

In simpler terms, this study suggests that using a technique that specifically aims to protect the LPN during surgery leads to better nerve health outcomes for patients. Additionally, while radiotherapy can cause some nerve damage, the nerve-sparing technique still performs better.

FAQs

  1. What are the two different surgical methods studied in relation to the health of the lateral pectoral nerve (LPN)?
  2. How does radiotherapy affect the health of the LPN in patients who had breast cancer surgery?
  3. Which surgical method was found to be more effective at preserving the health and function of the LPN?

Doctor’s Tip

Therefore, if you are considering a radical mastectomy, it may be beneficial to discuss with your doctor the possibility of using a nerve-sparing technique to help preserve the health of your nerves and potentially reduce the risk of nerve damage. Additionally, it is important to discuss the potential benefits and risks of radiotherapy in relation to nerve health. Your doctor can provide personalized recommendations based on your individual situation and help you make informed decisions about your treatment plan.

Suitable For

Patients with breast cancer who are recommended radical mastectomy, which involves the removal of the entire breast, chest wall muscles, and some lymph nodes, may benefit from a nerve-sparing technique to preserve the health and function of the lateral pectoral nerve. This is particularly important for patients who may be at higher risk for nerve damage due to factors such as the location or size of the tumor, the need for lymph node dissection, or the potential for post-operative radiotherapy.

Additionally, patients who are concerned about preserving the cosmetic appearance of their breasts and minimizing post-operative complications such as lymphedema may also be good candidates for a nerve-sparing technique. By preserving the health of the lateral pectoral nerve, patients may experience improved muscle function, decreased pain, and reduced risk of long-term nerve-related complications.

Overall, patients who are recommended radical mastectomy and may benefit from a nerve-sparing technique include those who are seeking to preserve nerve function, minimize post-operative complications, and optimize their overall quality of life following breast cancer surgery.

Timeline

  • Before radical mastectomy:
  1. Patient is diagnosed with breast cancer and undergoes various tests and imaging to determine the stage and extent of the cancer.
  2. Patient discusses treatment options with their healthcare team, which may include surgery, chemotherapy, radiation therapy, or a combination of these.
  3. Patient undergoes pre-operative assessments and preparation for surgery, including discussions about potential side effects and risks.
  4. Patient undergoes radical mastectomy surgery, which involves the removal of the entire breast, underlying chest muscles, and sometimes lymph nodes in the armpit.
  5. Patient may experience pain, discomfort, and limited range of motion in the affected arm and shoulder post-surgery.
  • After radical mastectomy:
  1. Patient starts rehabilitation and physical therapy to regain strength and mobility in the affected arm and shoulder.
  2. Patient may undergo additional treatments such as chemotherapy or radiation therapy based on the stage and type of breast cancer.
  3. Patient follows up with their healthcare team for regular check-ups and monitoring for any signs of recurrence.
  4. Patient may experience emotional and psychological effects of losing a breast and changes in body image.
  5. Patient may consider options for breast reconstruction surgery to restore the appearance of the breast.

Overall, the journey for a patient before and after radical mastectomy involves a combination of physical, emotional, and psychological challenges, but with proper support and care, many patients are able to adapt and thrive post-surgery.

What to Ask Your Doctor

  1. What is a radical mastectomy and how does it differ from other types of mastectomies?
  2. What are the potential risks and complications associated with a radical mastectomy?
  3. How will the surgery impact my daily activities and quality of life?
  4. Will I need additional treatments, such as chemotherapy or radiation therapy, after the surgery?
  5. What are the chances of nerve damage during the surgery and how will it be managed?
  6. How will the health of the lateral pectoral nerve be monitored post-surgery?
  7. What are the expected outcomes in terms of nerve function and overall recovery?
  8. Are there alternative surgical techniques that could minimize the risk of nerve damage?
  9. How long will it take to recover from a radical mastectomy and what can I expect during the recovery process?
  10. Are there any specific exercises or therapies that can help improve nerve health and function after the surgery?

Reference

Authors: Akkoca M, Ateş MP, Yılmaz KB, İmamoğlu İ, Balas Ş, Tokgöz S, Akıncı M, Karabacak H, Ünlü E. Journal: Asian J Surg. 2019 Mar;42(3):501-506. doi: 10.1016/j.asjsur.2018.08.003. Epub 2018 Sep 27. PMID: 30268639