Factors influencing arm and axillary symptoms after treatment for node negative breast carcinoma.
BACKGROUND
The purpose of the current study was to identify the factors that contribute to postoperative arm symptoms following breast conserving surgery in a well-defined cohort of node negative breast carcinoma patients.


METHODS
A convenience sample of 370 women >/= 50 years of age with node negative breast carcinoma who were participants in a randomized controlled trial designed to assess the need for breast radiation in addition to tamoxifen were surveyed. Axillary dissection was optional for patients 65 years or older and who were clinically node negative.


RESULTS
A total of 65.1% (241/370) of women had ipsilateral shoulder or arm symptoms. Multivariate analysis revealed that axillary dissection, breast radiation, and younger age (odds ratio = 11.2, 1.65, and 3.8 respectively) were significantly (P < 0.05) associated with increased ipsilateral shoulder or arm symptoms. Treatment with axillary dissection and breast radiation were significant factors (P < 0.02) associated with the self-reporting of arm swelling (odds ratio = 4.4 and 2.0, respectively). Patients 70 years old or greater reported significantly fewer arm symptoms (odds ratio = 0.26, P < 0.05) after axillary dissection.


CONCLUSIONS
Arm symptoms were present in about 80% of patients who underwent breast conserving surgery, axillary dissection, and breast radiation in the current study. These symptoms were significantly associated with the use of axillary dissection, breast radiation, and younger age. Older patients experienced fewer arm symptoms after standard treatment for node negative breast carcinoma, and thus older age should not be a contraindication to axillary dissection.
Yap
Karen P L
KP
Department of Surgical Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Canada.
McCready
David R
DR
Narod
Steven
S
Manchul
Lee A
LA
Trudeau
Maureen
M
Fyles
Anthony
A
D000367:Age Factors; D000368:Aged; D001132:Arm / Q000473:pathology*; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D004487:Edema / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects*; D008207:Lymphatic Metastasis; D015412:Mastectomy, Segmental / Q000009:adverse effects*; D008875:Middle Aged; D011183:Postoperative Complications; D012307:Risk Factors; D012782:Shoulder / Q000473:pathology