title: Short-term morbidity of the upper limb after sentinel lymph node biopsy or axillary lymph node dissection for Stage I or II breast carcinoma.
abstract: 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.
authors.affiliation: Department of Rehabilitation, Groningen University Hospital, Groningen, The Netherlands. j.s.rietman@rev.azg.nl
authors.forename: Johan S
authors.initials: JS
authors.lastname: Rietman
authors.forename: Pieter U
authors.initials: PU
authors.lastname: Dijkstra
authors.forename: Jan H B
authors.initials: JH
authors.lastname: Geertzen
authors.forename: Peter
authors.initials: P
authors.lastname: Baas
authors.forename: Jaap
authors.initials: J
authors.lastname: De Vries
authors.forename: Wil
authors.initials: W
authors.lastname: Dolsma
authors.forename: Johan W
authors.initials: JW
authors.lastname: Groothoff
authors.forename: Willem H
authors.initials: WH
authors.lastname: Eisma
authors.forename: Harald J
authors.initials: HJ
authors.lastname: Hoekstra
mesh_terms: 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