title: Morbidity results from the NSABP B-32 trial comparing sentinel lymph node dissection versus axillary dissection.
abstract: OBJECTIVE
  Three year post-surgical morbidity levels were compared between patients with negative sentinel lymph node dissection alone (SLND) and those with negative sentinel node dissection and negative axillary lymph node dissection (ALND) in the NSABP B-32 trial.
  
  
  METHODS
  A total of 1,975 ALND and 2,008 SLND node negative breast cancer patients had shoulder range of motion and arm volumes assessed along with self reports of arm tingling and numbness. Relative shoulder abduction deficits and relative arm volume differences between ipsilateral and contralateral arms were calculated.
  
  
  RESULTS
  Shoulder abduction deficits >or=10% peaked at 1 week for the ALND (75%) and SLND (41%) groups. Arm volume differences >or=10% at 36 months were evident for the ALND (14%) and SLND (8%) groups. Numbness and tingling peaked at 6 months for the ALND (49%, 23%) and SLND (15%, 10%) groups. Logistic regression correlates of residual morbidity included treatment group, age, handedness, tumor size, systemic chemotherapy, and radiation to the axilla.
  
  
  CONCLUSIONS
  Although residual morbidity for both treatment groups was evident, the results of the NSABP B-32 study indicate the superiority of the SLND compared to the ALND treatment approach relative to post-surgical morbidity outcomes over a 3-year follow-up period.
authors.affiliation: University of Vermont College of Medicine, Burlington, Vermont 05405, USA. takamaru.ashikaga@uvm.edu
authors.forename: Takamaru
authors.initials: T
authors.lastname: Ashikaga
authors.forename: David N
authors.initials: DN
authors.lastname: Krag
authors.forename: Stephanie R
authors.initials: SR
authors.lastname: Land
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Julian
authors.forename: Stewart J
authors.initials: SJ
authors.lastname: Anderson
authors.forename: Ann M
authors.initials: AM
authors.lastname: Brown
authors.forename: Joan M
authors.initials: JM
authors.lastname: Skelly
authors.forename: Seth P
authors.initials: SP
authors.lastname: Harlow
authors.forename: Donald L
authors.initials: DL
authors.lastname: Weaver
authors.forename: Eleftherios P
authors.initials: EP
authors.lastname: Mamounas
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Costantino
authors.forename: Norman
authors.initials: N
authors.lastname: Wolmark
mesh_terms: D001132:Arm / Q000503:physiopathology; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006987:Hypesthesia / Q000209:etiology / Q000503:physiopathology; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods*; D008209:Lymphedema / Q000209:etiology / Q000503:physiopathology; D008875:Middle Aged; D010292:Paresthesia / Q000209:etiology / Q000503:physiopathology; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D021701:Sentinel Lymph Node Biopsy; D012785:Shoulder Joint / Q000503:physiopathology