title: Morbidity of breast cancer patients following complete axillary dissection or sentinel node biopsy only: a comparative evaluation.
abstract: BACKGROUND
  The usefulness of routine axillary dissection (AD) at levels I-II in breast cancer patients has been questioned for years because of the high postoperative morbidity in the shoulder and arm region, and the increasing number of patients with negative nodes. Sentinel node biopsy (SNB) was hoped both to reduce morbidity and to improve the reliability of staging. This study was designed to provide more evidence in this matter by comparing the follow-up data of patients with AD and those with SNB only.
  
  
  METHODS
  One hundred forty patients who had undergone AD between 1993 and 1996 were questioned for their subjective and objective symptoms using a questionnaire and subsequently subjected to a clinical examination. Their data were compared with those of 57 patients who had undergone SNB only between 1998 and 2000.
  
  
  RESULTS
  Local recurrences have not been seen to date. The difference between the two groups in terms of a loss of quality of life was negligible. The differences in overall complaints, number of symptoms, pain, limited range of motion of the operated upper extremity, numbness, paresthesias, and arm swelling as well as perceived disability in activities of daily living were significantly in favor of SNB. The length of hospital stay was significantly shorter for SNB patients.
  
  
  CONCLUSIONS
  SNB appears to be an accurate procedure for axillary nodal staging in breast cancer patients and is associated with reduced postoperative morbidity and length of hospital stay. But it is still investigational and should not be implemented as therapeutical standard before results of randomized trials are published.
authors.affiliation: Department of General and Thoracic Surgery, Akademisches Lehrkrankenhaus der Universität Innsbruck, Feldkirch, Austria. anton.haid@cable.vol.at
authors.forename: Anton
authors.initials: A
authors.lastname: Haid
authors.forename: Roswitha
authors.initials: R
authors.lastname: Köberle-Wührer
authors.forename: Michael
authors.initials: M
authors.lastname: Knauer
authors.forename: Judit
authors.initials: J
authors.lastname: Burtscher
authors.forename: Heinz
authors.initials: H
authors.lastname: Fritzsche
authors.forename: William
authors.initials: W
authors.lastname: Peschina
authors.forename: Zerina
authors.initials: Z
authors.lastname: Jasarevic
authors.forename: Maria
authors.initials: M
authors.lastname: Ammann
authors.forename: Klaus
authors.initials: K
authors.lastname: Hergan
authors.forename: Heinz
authors.initials: H
authors.lastname: Sturn
authors.forename: Gerhard
authors.initials: G
authors.lastname: Zimmermann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008408:Mastectomy; D008875:Middle Aged; D009367:Neoplasm Staging; D021701:Sentinel Lymph Node Biopsy