Pilot feasibility study uses IONM for nerve identification during ALND (ICBN/MBCN monitoring)

University of Cincinnati is running an interventional, pilot feasibility study in breast cancer patients undergoing axillary lymph node dissection (ALND) to see whether intraoperative neuromonitoring (IONM)—a neurophysiology-based nerve stimulation/recording approach—can enable earlier identification and functional confirmation of the intercostobrachial nerve (ICBN), the medial brachial cutaneous nerve (MBCN), and their branches. The intervention places recording electrodes (including scalp and along cervical/brachial pathways) and uses stimulating electrodes to stimulate the median and ulnar nerves as reference pathways and system “integrity checks,” while exploring stimulation/recording parameters relevant to ICBN/MBCN during the dissection. The scientific angle is translation of established neurosurgical IONM workflows into breast/axillary surgery, where these sensory nerves are often at risk and can contribute to neuropathic post-surgical pain syndromes when injured. Today’s care for patients who require ALND is standard surgical dissection with visual nerve identification when feasible, plus routine perioperative analgesia; ICBN is commonly encountered and may be sacrificed depending on anatomy and oncologic needs, so this study tests whether real-time functional monitoring can support more consistent nerve recognition and protection.