Subjective morbidity and quality of life after sentinel node biopsy and axillary lymph node dissection for breast cancer.
OBJECTIVE
Sentinel node (SN) biopsy is a minimally invasive surgical method for axillary staging in patients with breast cancer. The aim of this study was to evaluate mid-term morbidity after SN biopsy and axillary lymph node (ALN) dissection in patients with breast cancer receiving breast-sparing treatment, and to determine its impact on quality of life (QOL).


METHODS
One hundred fifteen patients with breast cancer underwent breast-conserving treatment with SN biopsy alone (Group 1: n = 54), ALN dissection with or without SN biopsy (Group 2: n = 51), or SN biopsy followed by later ALN dissection (Group 3: n = 10).


RESULTS
The mean post-operative follow-up was 20.3 months (range: 10-31 months) in Group 1, 24.3 months (range: 10-33 months) in Group 2, and 19.1 months (range: 12-28 months) in Group 3. Arm-shoulder pain was reported by 21.2% of patients in Group 1, 52.9% in Group 2, and 60% in Group 3 (P = 0.002). An arm swelling sensation was reported by 0% of patients in Group 1, 21.6% in Group 2, and 10% in Group 3. Dysesthesias were reported by 5.7% of patients in Group 1, 51% in Group 2, and 50% in Group 3 (P < 0.001). The mean global QOL self-rating score was 7.6 in Group 1, 7.6 in Group 2, and 7.7 in Group 3 (no significant difference).


CONCLUSIONS
SN biopsy is associated with significantly lower mid-term morbidity than ALN dissection.
Barranger
Emmanuel
E
Department of Gynecologic and Breast Cancers, Hôpital Tenon, 4 rue de la Chine, Paris, France. emmanuel.barranger@tnn.ap-hop-paris.fr
Dubernard
Gil
G
Fleurence
José
J
Antoine
Martine
M
Darai
Emile
E
Uzan
Serge
S
D000328:Adult; D000368:Aged; D001132:Arm / Q000503:physiopathology*; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects*; D008875:Middle Aged; D011788:Quality of Life; D021701:Sentinel Lymph Node Biopsy / Q000009:adverse effects*