title: Physical function of the upper limb after breast cancer surgery. Results from the SOUND (Sentinel node vs. Observation after axillary Ultra-souND) trial.
abstract: BACKGROUND
  The SOUND (Sentinel node vs. Observation after axillary Ultra-souND) trial is an ongoing prospective randomized study comparing sentinel node biopsy vs. no axillary surgical staging in patients with small breast cancer and negative pre-operative ultra-sound of the axilla.
  
  
  METHODS
  The first 180 recruited patients were administered the QuickDASH (Disability Arm and Shoulder) questionnaire at different time points (before surgery, 1 week, 6 months and 1 year after surgery) to evaluate the physical function of the ipsilateral upper limb, The QuickDASH score ranges from 0 (no disability) to 100 (complete disability).
  
  
  RESULTS
  176 patients were available for analysis (94 in SNB arm and 82 in observation arm). The two groups were comparable with respect to age, tumor characteristics and treatments. Pre-surgery score values were 3.0% and 2.7% in the SNB arm and observation arm, respectively (P = 0.730). One week after surgery, the score increased to 24.0% in the SNB arm and 10.6% in the observation arm (P < 0.001). After 6 and 12 months, the score decreased in both arms to values similar to baseline values. The overall trend in time of the score was significantly different between the two arms (P < 0.001), even after the exclusion of five patients who received AD in the SNB arm (P < 0.001).
  
  
  CONCLUSIONS
  Patients who underwent SNB had a significantly higher rate of disability in the early post-operative period compared to patients who did not. The avoidance of SNB might translate into a considerable reduction of physical and emotional distress.
authors.affiliation: Division of Breast Surgery, European Institute of Oncology, Via G. Ripamonti 435, 20141 Milan, Italy. Electronic address: gentilini.oreste@hsr.it.
authors.forename: O
authors.initials: O
authors.lastname: Gentilini
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Via G. Ripamonti 435, 20141 Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Botteri
authors.affiliation: Physiotherapy Service, European Institute of Oncology, Via G. Ripamonti 435, 20141 Milan, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Dadda
authors.affiliation: European Institute of Oncology, Via G. Ripamonti 435, 20141 Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Sangalli
authors.affiliation: Division of Breast Surgery, European Institute of Oncology, Via G. Ripamonti 435, 20141 Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Boccardo
authors.affiliation: Division of Breast Surgery, European Institute of Oncology, Via G. Ripamonti 435, 20141 Milan, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Peradze
authors.affiliation: European Institute of Oncology, Via G. Ripamonti 435, 20141 Milan, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Ghisini
authors.affiliation: Division of Breast Surgery, European Institute of Oncology, Via G. Ripamonti 435, 20141 Milan, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Galimberti
authors.affiliation: Division of Breast Surgery, European Institute of Oncology, Via G. Ripamonti 435, 20141 Milan, Italy; University of Milan, European Institute of Oncology, Via G. Ripamonti 435, 20141 Milan, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Veronesi
authors.affiliation: Division of Breast Surgery, European Institute of Oncology, Via G. Ripamonti 435, 20141 Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Luini
authors.affiliation: Division of Breast Radiology, European Institute of Oncology, Via G. Ripamonti 435, 20141 Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Cassano
authors.affiliation: Department of Pathology and Laboratory Medicine, European Institute of Oncology, Via G. Ripamonti 435, 20141 Milan, Italy; University of Milan, European Institute of Oncology, Via G. Ripamonti 435, 20141 Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Viale
authors.affiliation: Scientific Directorate, European Institute of Oncology, Via G. Ripamonti 435, 20141 Milan, Italy.
authors.forename: U
authors.initials: U
authors.lastname: Veronesi
mesh_terms: D000368:Aged; D001132:Arm / Q000503:physiopathology*; D001365:Axilla / Q000000981:diagnostic imaging*; D001943:Breast Neoplasms / Q000601:surgery*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D020127:Recovery of Function; D021701:Sentinel Lymph Node Biopsy / Q000009:adverse effects*; D014463:Ultrasonography
keywords: Axillary dissection; Breast cancer; Physical function; Sentinel node biopsy