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.
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.
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.
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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Warmuth MA, Bowen G, Prosnitz LR, et al. Complications of axillary lymph node dissection for carcinoma of the breast: a report based on a patient survey.Cancer 1998;83:1362–8.
Hack TF, Cohen L, Katz J, Robson LS, Goss P. Physical and psychological morbidity after axillary lymph node dissection for breast cancer.J Clin Oncol 1999;17:143–9.
Petrek JA, Senie RT, Peters M, Rosen PP. Lymphedema in a cohort of breast carcinoma survivors 20 years after diagnosis.Cancer 2001;92:1368–77.
Roses DF, Brooks AD, Harris MN, Shapiro RL, Mitnick J. Complications of level I and II axillary dissection in the treatment of carcinoma of the breast.Ann Surg 1999;230:194–201.
Velanovich V, Szymanski W. Quality of life of breast cancer patients with lymphedema.Am J Surg 1999;177:184–7.
Lucci A, Kelemen PR, Miller C, Chardkoff L, Wilson L. National practice patterns of sentinel lymph node dissection for breast carcinoma.J Am Coll Surg 2001;192:453–8.
Roumen RM, Kuijt GP, Liem IH, van Beek MW. Treatment of 100 patients with sentinel node-negative breast cancer without further axillary dissection.Br J Surg 2001;88:1639–43.
Schrenk P, Rieger R, Shamiyeh A, Wayand W. Morbidity following sentinel lymph node biopsy versus axillary lymph node dissection for patients with breast carcinoma.Cancer 2000;88:608–14.
Burak WE, Hollenbeck ST, Zervos EE, Hock KL, Kemp LC, Young DC. Sentinel lymph node biopsy results in less postoperative morbidity compared with axillary lymph node dissection for breast cancer.Am J Surg 2002;183:23–7.
Sener SF, Winchester DJ, Martz CH, et al. Lymphedema after sentinel lymphadenectomy for breast carcinoma.Cancer 2001;92: 748–52.
Giuliano AE, Haigh PI, Brennan MB, et al. Prospective observational study of sentinel lymphadenectomy without further axillary dissection in patients with sentinel node-negative breast cancer.J Clin Oncol 2000;18:2553–9.
Baron RH, Kelvin JF, Bookbinder M, Cramer L, Borgen PI, Thaler HT. Patients’ sensations after breast cancer surgery: a pilot study.Cancer Pract 2000;8:215–22.
Baron R, Fey J, Thaler H, Borgen PI, Temple LKF, Van Zee K. Eighteen sensations after breast cancer surgery: a comparison of sentinel lymph node biopsy and axillary lymph node dissection.Oncol Nurs Forum 2002;29:651–9.
Maunsell E, Brisson J, Deschenes L. Arm problems and psychological distress after surgery for breast cancer.Can J Surg 1993; 36:315–20.
Tasmuth T, von Smitten K, Kalso E. Pain and other symptoms during the first year after radical and conservative surgery for breast cancer.Br J Cancer 1996;74:2024–31.
Coster S, Poole K, Fallowsfield LJ. The validation of a quality of life scale to assess the impact of arm morbidity in breast cancer patients post-operatively.Breast Cancer Res Treat 2001;68:273–82.
Aday LA.Designing and Conducting Health Surveys: A comprehensive Guide. 2nd ed. San Francisco: Jossey-Bass, 1996.
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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
- Sentinel lymph node biopsy
- Axillary dissection
- Breast cancer