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* Axillary sampling. tA xillary clearance. $ Range of Motion. ^Mastectomy patients. § Lumpectomy patients.

* Axillary sampling. tA xillary clearance. $ Range of Motion. ^Mastectomy patients. § Lumpectomy patients.

Brachial Plexopathy

Brachial plexopathy after radiation therapy is uncommon and typically seen only when regional nodal irradiation has been delivered. The clinical syndrome most frequently presents with paresthesias, and is associated with pain and/or weakness in the ipsilat-eral arm.134'135 Weakness tends to be slowly progressive. The onset of symptoms can be seen within 6 months of completing radiation. While some studies document that most patients develop symptoms within 3 years,134 others have demonstrated that the risk is progressive with time.135'136 The entire brachial plexus is typically involved,134'135 though some cases have documented involvement of just the upper or lower trunk. The mechanism of radiation-induced brachial plexopathy is not completely understood, but it is suspected that fibrosis of tissue around peripheral nerves occurs with injury to small vessels that leads to ischemia. Pathologic studies have shown loss of myelin, fibrosis and thickening of the neurolemma sheath, and obliteration of the

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