A multidisciplinary approach for the treatment of metastatic brachial plexus neuropathy from breast cancer: neurosurgical, plastic, and radiotherapeutic.

A new approach for the treatment of metastatic brachial plexus neuropathy at the axillary level is described. This may be used in patients previously submitted to radical mastectomy followed by radiotherapy for breast cancer. The method consists of external neurolysis of the cords of the plexus, dissection and excision of the pathological axillary contents along with the overlying atrophic cutaneous and subcutaneous tissues, reconstruction of the axilla by the latissimus dorsi musculocutaneous flap, and finally early radiotherapy by high-dose radiation delivered to the entire area. The advantages of the procedure are briefly discussed.