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Sensory morbidity after sentinel lymph node biopsy and axillary dissection: A prospective study of 233 women

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Abstract

Background

We prospectively compared the sensory morbidity and lymphedema experienced after sentinel node biopsy (SLNB) and axillary dissection (ALND) over a 12-month period by using a validated instrument.

Methods

Patients undergoing breast-conserving therapy completed the Breast Sensation Assessment Scale (BSAS) at baseline and 3, 6, and 12 months after surgery. Repeated-measures analysis of variance was used to compare ALND and SLNB over the 12-month period. Upper- and lower-arm circumference measurements at baseline and 12 months were used to assess lymphedema.

Results

SLNB was associated with substantial sensory morbidity, although significantly less than ALND, over time on all four subscales and the summary score. A statistically significant improvement in sensory morbidity occurred for both groups in the first 3 months, with no further change thereafter. For both types of axillary surgery, younger patients had significantly higher BSAS scores than older patients. There was no significant difference in arm circumference between patients with SLNB and ALND at 12 months.

Conclusions

Among women undergoing breast-conserving therapy, SLNB has significant sensory morbidity, although approximately half that of ALND. Sensory morbidity improves in the first 3 months after surgery, but patients continue to report sensory morbidity at 1 year. Longitudinal follow-up is required to further assess lymphedema.

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Authors and Affiliations

  1. Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., MRI 1026, 10021, NY, New York

    Larissa K. F. Temple MD, MSc

  2. Breast Service, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., MRI 1026, 10021, New York, NY

    Roberta Baron MSN, AOCN©, Hiram S. Cody III MD, Jane V. Fey MPH, Patrick I. Borgen MD, Alexander S. Heerdt MD, Leslie L. Montgomery MD, Jeanne A. Petrek MD & Kimberly J. Van Zee MS, MD

  3. Department of Biostatistics, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., MRI 1026, 10021, New York, NY

    Howard T. Thaler PhD

Authors
  1. Larissa K. F. Temple MD, MSc
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  2. Roberta Baron MSN, AOCN©
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  3. Hiram S. Cody III MD
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  4. Jane V. Fey MPH
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  5. Howard T. Thaler PhD
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  6. Patrick I. Borgen MD
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  7. Alexander S. Heerdt MD
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  8. Leslie L. Montgomery MD
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  9. Jeanne A. Petrek MD
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  10. Kimberly J. Van Zee MS, MD
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Corresponding author

Correspondence to Kimberly J. Van Zee MS, MD.

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Temple, L.K.F., Baron, R., Cody, H.S. et al. Sensory morbidity after sentinel lymph node biopsy and axillary dissection: A prospective study of 233 women. Annals of Surgical Oncology 9, 654–662 (2002). https://doi.org/10.1007/BF02574481

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  • DOI: https://doi.org/10.1007/BF02574481

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