Short-term morbidity of the upper limb after sentinel lymph node biopsy or axillary lymph node dissection for Stage I or II breast carcinoma.
BACKGROUND
The goals of sentinel lymph node biopsy (SLNB) are to improve axillary staging and reduce unnecessary axillary lymph node dissections (ALND), thereby reducing treatment-related upper-limb morbidity. In the current prospective study, short-term upper-limb morbidity was assessed after SLNB and/or ALND.


METHODS
The study comprised 204 patients with Stage I/II breast carcinoma. Mean patient age was 55.6 years (standard deviation, 11.6). Sixty-six patients (32%) underwent SLNB only, and 138 (68%) underwent a Level I-II ALND. Assessment (preoperative [t0] and 6 weeks postoperative [t1]) included evaluation of shoulder range of motion, muscle strength, grip strength, pain, upper/forearm circumference, shoulder disability, and activities of daily life (ADL).


RESULTS
Considerable treatment-related upper-limb morbidity was observed. Significant (P < 0.001) changes were found for pain, range of motion in forward flexion, abduction and abduction/external rotation, strength of shoulder abductors and elbow flexors, and in perceived disability in ADL. However, no significant difference in change of upper-limb function and ADL was found between the SLNB and ALND groups.


CONCLUSIONS
Significant short-term treatment-related upper-limb morbidity exists after SLNB or ALND. There is no significant difference in short-term treatment-related morbidity between SLNB and ALND.
Rietman
Johan S
JS
Department of Rehabilitation, Groningen University Hospital, Groningen, The Netherlands. j.s.rietman@rev.azg.nl
Dijkstra
Pieter U
PU
Geertzen
Jan H B
JH
Baas
Peter
P
De Vries
Jaap
J
Dolsma
Wil
W
Groothoff
Johan W
JW
Eisma
Willem H
WH
Hoekstra
Harald J
HJ
D000203:Activities of Daily Living; D001132:Arm / Q000503:physiopathology; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D004487:Edema / Q000209:etiology; D005260:Female; D018737:Hand Strength; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects*; D008875:Middle Aged; D009068:Movement; D010146:Pain / Q000209:etiology; D011446:Prospective Studies; D016059:Range of Motion, Articular; D021701:Sentinel Lymph Node Biopsy / Q000009:adverse effects*; D012785:Shoulder Joint / Q000503:physiopathology; D011795:Surveys and Questionnaires