Objective: To investigate the feasibility of preserving the intercostal nerve (ICBN) in sentinel lymph node biopsy (SLNB) of breast cancer. Methods: A retrospective analysis of 184 patients with breast cancer sentinel lymph node biopsy was performed. ICBN was performed in all the patients, and 134 patients underwent sentinel lymph node biopsy (ICBN). The operation time, blood loss, number of lymph nodes and postoperative complications were compared between the two groups, and the skin paresthesia, pain and prognosis of the patients with axillary and medial upper arm were observed. Results: There was no significant difference in operation time, blood loss, number of lymph node dissection and postoperative complications between the ICBN group and the control group. There was no statistically significant difference in the incidence of abnormal sensation in the armpit and upper arm in 3 days after operation. While the upper medial arm and axilla skin paresthesia after 0.5–3 months had significant difference, preserve the ipsilateral upper medial arm and axilla skin paresthesia group lower rates of remission 3 months after operation and ICNB, the difference was statistically significant. Conclusion: SLNB of ICBN preservation in breast cancer does not increase the difficulty of operation. It can reduce patient’s postoperative side arm paresthesia and the incidence of pain, can improve the quality of life of patients after operation, SLNB of ICBN preservation in breast cancer is safe and feasible.