Shoulder–arm morbidity following axillary dissection and sentinel node only biopsy for breast cancer

doi:10.1053/ejso.2002.1327

European Journal of Surgical Oncology (EJSO)

Volume 28, Issue 7, November 2002, Pages 705-710

https://doi.org/10.1053/ejso.2002.1327 Get rights and content

Abstract

Aims: The purpose of this study was to examine the outcome of shoulder–arm morbidity in patients with breast cancer after various axillary staging procedures. We used a new specific summation score to compare conventional axillary node dissection (AD) and sentinel node only biopsy for postoperative shoulder–arm morbidity.

Methods: Eighty-five patients undergoing conventional AD and 66 patients undergoing sentinel node biopsy were evaluated both subjectively (questionnaire) and objectively (clinical examination) for reduced muscle strength, limited range of motion, lymphedema and pain, dysesthesias and loss of sensitivity. The symptoms elicited were rated by their severity with a single summation score describing all symptoms reported.

Results: Subjective evaluation of patients undergoing breast conserving surgery showed a highly significant difference in favor of SNB only (P≤0.002). On clinical examination the outcome of patients with SNB only was also significantly or highly significantly better (difference in arm volume:P =0.007; difference in arm muscle strength: P=0.016; loss of sensitivity: P<0.001). Of a total score of 100 (=no symptoms), the mean for AD patients was 80.2 vs 92.8 for SNB patients (P=0.001). In patients undergoing total mastectomy the difference was only significant for pain sensations and total scores.

Conclusions: SNB appears to reduce morbidity. Summation scores are a suitable and practicable tool for describing the symptoms associated with axillary surgery.

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^f1: Correspondence to: Anton Haid, MD, Landeskrankenhaus Feldkirch, Teaching Hospital, University of Innsbruck, Carinagasse 47, A-6800 Feldkirch, Austria. Tel: +4355223039245; E-mail: [email protected]

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Regular ArticleShoulder–arm morbidity following axillary dissection and sentinel node only biopsy for breast cancer

Abstract

Eur J Cancer

Lancet

The Breast

Relation of tumor size, lymph node status and survival in 24 740 breast cases

Cancer

Fisher: Pathologic findings from the National Surgical Adjuvant Project for Breast Cancers (protocol no B: Pathologic findings from the National Surgical Adjuvant Project for Breast Cancers (protocol no. 4)

Cancer

A contemporary view of axillary dissection

Ann Surg

Breast cancer patients treated without axillary surgery

Ann Surg

A survival benefit from axillary dissection: was Halsted correct?

Ann Surg Oncol

Arm morbidity following treatment of breast cancer with total axillary dissection: a multivariate approach

Oncology

Physical and psychological morbidity after axillary lymph node dissection for breast cancer

J Clin Oncol

Risk of lymphoedema following the treatment of breast cancer

Br J Surg

Long-term morbidity following axillary dissection in breast cancer patients – clinical assessment, significance for life quality and the impact of demographic, oncologic and therapeutic factors

Breast Cancer Res Treat

Morbidity of breast cancer patients following complete axillary dissection or sentinel node biopsy only: a comparative evaluation

Breast Cancer Res Treat

Regular Article
Shoulder–arm morbidity following axillary dissection and sentinel node only biopsy for breast cancer