title: A multicenter cohort study to compare quality of life in breast cancer patients according to sentinel lymph node biopsy or axillary lymph node dissection.
abstract: BACKGROUND
  This prospective multicenter study assessed and compared the impact of different surgical procedures on quality of life (QoL) in breast cancer patients.
  
  
  METHODS
  The EORTC QLQ-C30 and the EORTC QLQ-BR-23 questionnaires were used to assess global health status (GHS), arm (BRAS) and breast (BRBS) symptom scales, before surgery, just after surgery and 6 and 12 months later. The Kruskal-Wallis test with the Bonferroni correction was used to compare scores. A mixed model analysis of variance for repeated measurements was then applied to assess the longitudinal effect of surgical modalities on QoL.
  
  
  RESULTS
  Before surgery, GHS (P = 0.7807) and BRAS (P = 0.7688) QoL scores were similar whatever the surgical procedure: sentinel node biopsy (SLNB), axillary node dissection (ALND) or SLNB + ALND. As compared with other surgical groups, GHS 75.91 [standard deviation (SD) = 17.44, P = 0.041] and BRAS 11.39 (SD = 15.36, P < 0.0001) were better in the SLNB group 12 months after surgery. Whatever the type of surgery, GHS decreased after surgery (P < 0.0001), but increased 6 months later (P = 0.0016). BRAS symptoms increased just after surgery (P = 0.0329) and until 6 months (P < 0.0001) before decreasing (P < 0.0001).
  
  
  CONCLUSIONS
  SLNB improved GHS and BRAS QoL in breast cancer patients. However, surgeons must be cautious, SLNB with ALND results in a poorer QoL.
authors.affiliation: Biostatistics and Epidemiology Unit, Medical Information Department, Centre Georges François Leclerc, Dijon, France. sdabakuyo@dijon.fnclcc.fr
authors.forename: T S
authors.initials: TS
authors.lastname: Dabakuyo
authors.forename: J
authors.initials: J
authors.lastname: Fraisse
authors.forename: S
authors.initials: S
authors.lastname: Causeret
authors.forename: S
authors.initials: S
authors.lastname: Gouy
authors.forename: M-M
authors.initials: MM
authors.lastname: Padeano
authors.forename: C
authors.initials: C
authors.lastname: Loustalot
authors.forename: J
authors.initials: J
authors.lastname: Cuisenier
authors.forename: J-M
authors.initials: JM
authors.lastname: Sauzedde
authors.forename: M
authors.initials: M
authors.lastname: Smail
authors.forename: J-P
authors.initials: JP
authors.lastname: Combier
authors.forename: P
authors.initials: P
authors.lastname: Chevillote
authors.forename: C
authors.initials: C
authors.lastname: Rosburger
authors.forename: S
authors.initials: S
authors.lastname: Boulet
authors.forename: P
authors.initials: P
authors.lastname: Arveux
authors.forename: F
authors.initials: F
authors.lastname: Bonnetain
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D021701:Sentinel Lymph Node Biopsy