The intercostobrachial nerve is the lateral cutaneous branch of the second intercostal nerve (T2). It emerges through the second intercostal space in the mid-axillary line, crosses the axilla and joins the medial cutaneous nerve of the arm, supplying the skin of the axillary floor and the upper medial and posterior arm. It is the only nerve to the skin of the arm that does not come from the brachial plexus, and the sensory nerve most often damaged in axillary lymph node dissection for breast cancer.
| Origin | Lateral cutaneous branch of the second intercostal nerve (T2) |
|---|---|
| Course | Pierces the second intercostal space in the mid-axillary line, crosses the axilla through the axillary fat and joins the medial cutaneous nerve of the arm to supply the upper medial arm |
| Motor |
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| Sensory |
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Intercostobrachial nerve injury during axillary dissection is the most common cause of sensory symptoms after axillary surgery, producing numbness, tingling or allodynia over the medial upper arm and axilla that can persist for years and contributes to post-mastectomy pain syndrome. Nerve-sparing techniques that identify and preserve it reduce these symptoms. It is often sacrificed in full axillary clearance but can usually be preserved in sentinel node biopsy. When it is divided the numbness is usually permanent, so patients should be counselled before surgery.
Persistent medial arm and axillary pain from intercostobrachial nerve damage during axillary surgery, producing numbness and allodynia that affects quality of life in breast cancer survivors.
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