J Korean Surg Soc.  2007 Jun;72(6):488-490.

Proximal Variation of the Long Thoracic Nerve would be Vulnerable to Injury during an Axillary Dissection

• Si Y
• Kim SS
• Lee JS
• Jeon HM
• Lee JH
• Park WC

Abstract

Herein, our experience of a rare variation of the long thoracic nerve during an axillary dissection in a female patient with a breast ductal carcinoma in situ (DCIS) is reported. Her long thoracic nerve was duplicated and united at its proximal and distal parts, respectively. She was a 45-year old female, with microcalcification on her left breast, which had been diagnosed as a DCIS by a stereotactic core needle biopsy. Due to the diffuse distribution of lesions, a mastectomy was performed, with immediate reconstruction using a transverse rectus abdominis muscle (TRAM) free flap. After the mastectomy, an axillary dissection was performed for anastomoses of the free flap to the thoracodorsal vessels, at which point the duplicated variation of the proximal part of the long thoracic nerve was found. This variation is very rare, and would be vulnerable to injury during an axillary dissection. Therefore, surgeons should take care to avoid injury to such a nerve during axillary surgery.

Keyword

Long thoracic nerve; Variation; Axilla; Breast cancer

MeSH Terms

Axilla
Biopsy, Large-Core Needle
Breast
Breast Neoplasms
Carcinoma, Intraductal, Noninfiltrating
Female
Free Tissue Flaps
Humans
Mastectomy
Middle Aged
Rectus Abdominis
Thoracic Nerves*