Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Comparison of side effects between sentinel lymph node and axillary lymph node dissection for breast cancer

  • 302 Accesses

  • 171 Citations



Axillary lymph node dissection (ALND) is often associated with permanent arm side effects. Side effects after sentinel lymph node dissection (SLND) should be less common, because the surgery is less extensive.


The study compared side effects and interference with daily life between 169 women who underwent an SLND and 78 who underwent an ALND for breast cancer. Patients rated symptom severity and interference with daily life caused by pain, numbness, limitation of arm range of motion (ROM), and arm swelling at 1, 6, and 12 months after surgery by using the Measure of Arm Symptom Survery. Repeated-measures and regression analyses for each time period were used to determine associations between symptoms and dissection type.


At 1 month, SLND patients reported less pain, numbness, limitation in ROM, and seromas than ALND patients. At 6 months, SLND patients had less pain, numbness, and arm swelling, and at 12 months, SLND patients had less numbness, arm swelling, and limitation in ROM than ALND patients. At 1 month, pain, numbness, and limitation in ROM interfered significantly more with daily life for ALND patients. At 6 and 12 months, only numbness interfered more with daily life for ALND patients.


SLND was associated with fewer side effects than ALND at all time points.

This is a preview of subscription content, log in to check access.


  1. 1.

    Early stage breast cancer.Consens Statement 1990;8:1–19.

  2. 2.

    Kakuda JT, Stuntz M, Trivedi V, Klein SR, Vargas HI. Objective assessment of axillary morbidity in breast cancer treatment.Am Surg 1999;65:995–8.

  3. 3.

    Edwards TL. Prevalence and aetiology of lymphedema after breast cancer treatment in southern Tasmania.Aust N Z J Surg 2000;70: 412–8.

  4. 4.

    Hoe AL, Iven D, Royle GT, Taylor I. Incidence of arm swelling following axillary olerance for branst cancer.Br J Surg 1992;79: 261–2.

  5. 5.

    Hojris I, Andersen J, Overgaard M, Overgaard J. Late treatment-related morbidity in breast cancer patients randomized to postmastectomy radiotherapy and systemic treatment versus systemic treatment alone.Acta Oncol 2000;39:355–72.

  6. 6.

    Ivens D, Hoe AL, Podd TJ, Hamilton CR, Taylor I, Royle GT. Assessment of morbidity from complete axillary dissection.Br J Cancer 1992;66:136–8.

  7. 7.

    Keramopoulos A, Tsionou C, Minaretzis D, Michalas S, Aravantinos D. Arm morbidity following treatment of breast cancer with total axillary dissection: a multivariated approach.Oncology 1993; 50:445–9.

  8. 8.

    Kiel KD, Rademacker AW. Early-stage breast cancer: arm edema after wide excision and breast irradiation.Radiology 1996;198: 279–83.

  9. 9.

    Kissin MW, Rovere GQD, Easton D, Westburg G. Risk of lymphoedema following the treatment of breast cancer.Br J Surg 1986;73:580–4.

  10. 10.

    Liljegren G, Holmberg L. Arm morbidity after sector resection and axillary dissection with or without postoperative radiotherapy in breast cancer stage I. Results from a randomised trial. Uppsala-Orebro Breast Cancer Study Group.Eur J Cancer 1997;33:193–9.

  11. 11.

    Maunsell E, Brisson J, Deschenes L. Arm problems and psychological distress after surgery for breast cancer.Can J Surg 1993; 36:315–79.

  12. 12.

    Paci E, Cariddi A, Barchielli A, et al. Long-term sequelae of breast cancer surgery.Tumori 1996;82:321–4.

  13. 13.

    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.

  14. 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.

  15. 15.

    Sener SF, Winchester DJ, Martz CH, et al. Lymphedema after sentinel lymphadenectomy for breast carcinoma.Cancer 2001;92: 748–52.

  16. 16.

    Baron RH, Fey JV, Shi W, Raboy S, Thaler HT, VanZee KJ. A prospective study of patient sensations following breast cancer surgery (abstract).Oncol Nurs Forum 2001;28:322.

  17. 17.

    Stotter A, Chandler T. Breast cancer: outcome audit of axillary management in 1991.Eur J Surg Oncol 1999;25:261–4.

  18. 18.

    Suneson BL, Lindholm C, Hamrin E. Clinical incidence of lymphoedema in breast cancer patients in Jonkoping County, Sweden.Eur J Cancer Care (Engl) 1996;5:7–12.

  19. 19.

    Tasmuth T, vonSmitten 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.

  20. 20.

    Tengrup I, Tennvall-Nittby L, Christiansson I, Laurin M. Arm morbidity after breast-conserving therapy for breast cancer.Acta Oncol 2000;39:393–7.

  21. 21.

    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.

  22. 22.

    Carter BJ. Women's experiences of lymphedema.Oncol Nurs Forum 1997;24:875–82.

  23. 23.

    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.

  24. 24.

    Passik SD, McDonald MV. Psychosocial aspects of upper extremity lymphedema in women treated for breast carcinoma.Cancer 1998;83:2817–20.

  25. 25.

    Tobin MB, Lacey HJ, Meyer L, Mortimer PS. The psychosocial morbidity of breast cancer-related arm swelling. Psychological morbidity of lymphoedema.Cancer 1993;72:3248–52.

  26. 26.

    Velanovich V, Szymanski W. Quality of life of breast cancer patients with lymphedema.Am J Surg 1999;177:184–7.

  27. 27.

    Albertini JJ, Lyman GH, Cox C, et al. Lymphatic mapping and sentinel node biopsy in the patient with breast cancer.JAMA 1996;276:1818–22.

  28. 28.

    Edwards MJ, Giuliano A, Reintgen D, Tafra L, Whitworth P.Revised Consensus Statement on Guidelines for Performance of Sentinel Lymphadenectomy for Breast Cancer. American Society of Breast Surgeons. 2000. Available at: http://www.breastsurgeons. org/sentinel.shtml.

  29. 29.

    Giuliano AE, Kirgan DM, Guenther JM, Morton DL. Lymphatic mapping and sentinel lymphadenectomy for breast cancer.Ann Surg 1994;220:391–401.

  30. 30.

    Krag DN, Weaver DL, Ashikaga T, et al. The sentinel node in breast cancer—a multicenter validation study.N Engl J Med 1998; 339:941–6.

  31. 31.

    Martin RC II, Edward MJ, Wong SL, et al. Practical guidelines for optimal gamma probe detection of sentinel lymph nodes in breast cancer: results of a multi-institutional study.Surgery 2000;128: 139–44.

  32. 32.

    McMasters KM, Tuttle TM, Carlson DJ, et al. Sentinel lymph node biopsy for breast cancer: a suitable alternative to routine axillary dissection in multi-institutional practice when optimal technique is used.J Clin Oncol 2000;18:2560–6.

  33. 33.

    Giuliano AE, Dale PS, Turner RR, Morton DL, Evans SW, Krasne DL. Improved axillary staging of breast cancer with sentinel lymphadenectomy.Ann Surg 1997;222:394–9.

  34. 34.

    Turner RR, Ollila DW, Stern S, Giuliano AE. Optimal histopathologic examination of the sentinel lymph node for breast carcinoma staging.Am J Surg Pathol 1999;23:263–7.

  35. 35.

    SAS Institute Inc.SAS/STAT Software. Changes and Enhancements Through Release 6.12. Cary, NC: SAS Institute, 1997.

  36. 36.

    Kuehn T, Klauss W, Darsow M, et al. 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 2000;64:275–86.

Download references

Author information

Correspondence to Karen K. Swenson RN, MS, AOCN.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Swenson, K.K., Nissen, M.J., Ceronsky, C. et al. Comparison of side effects between sentinel lymph node and axillary lymph node dissection for breast cancer. Annals of Surgical Oncology 9, 745–753 (2002). https://doi.org/10.1007/BF02574496

Download citation

Key Words

  • Breast cancer
  • Surgery
  • Axilla
  • Sentinel lymph node
  • Arm side effects