[Morbidity after sentinel node biopsy and axillary dissection in breast cancer].
BACKGROUND
The aim of this study was to evaluate the morbidity after sentinel node biopsy (SNB) and axillary dissection with (AD-NS) or without sparing the intercostobrachial nerve (AD-NOS).


METHODS
A prospective cohort study was performed on 108 patients divided into three groups: SNB (n=35), AD-NS (n=36) and AD-NOS (n=37). We evaluated the incidence of sensory loss, pain, lymphedema, seroma formation and infection in the arm homolateral to the breast surgery. Semmes-Weinstein monofilaments were used to assess the sensory loss; brachial perimetry was used to evaluate presence of lymphedema and a pain questionnaire was administered. ANOVA and Kruskal-Wallis statistical tests were used. Bivariate and Multivariate analyses were performed.


RESULTS
After surgery at least one complication was reported by 45/108 (41.7%) patients. Pain was the outcome more often reported by patients. In the three groups a significant difference was observed only regarding sensory loss (p=0.04). Pain, lymphedema, and sensory loss were more frequently found in the AD-NOS group. No significant difference was observed between SNB and AD-NS groups. Semmes-Weinstein monofilaments showed preservation of cutaneous sensitivity in 28/35 patients from the SNB group, in 25/36 patients from AD-NS group but in only 10/37 patients from AD-NOS group (p<0.001).


CONCLUSIONS
The ICB section is associated with higher sensory loss, with statistically significant difference between the groups that were not shown to be significant with the others complications.
Ferreira
Beatriz Pifano Soares
BP
Universidade Federal de Minas Gerais, Departamento de Anatomia Patológia, Belo Horizonte, MG.
Pimentel
Mônica Duarte
MD
Santos
Luiz Cláudio dos
LC
di Flora
Walace
W
Gobbi
Helenice
H
D000704:Analysis of Variance; D001365:Axilla / Q000601:surgery; D001917:Brachial Plexus / Q000601:surgery; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects* / Q000592:standards; D008209:Lymphedema; D008408:Mastectomy / Q000009:adverse effects* / Q000592:standards; D015999:Multivariate Analysis; D010146:Pain / Q000209:etiology; D011446:Prospective Studies; D018709:Statistics, Nonparametric