Background:The aim of this study was to assess long-term quality of life (QoL) over a period of 6 years in women with breast cancer (BC) who underwent sentinel lymph node biopsy (SLNB), axillary lymph node dissection (ALND), or SLNB followed by ALND.Methods:The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ)-C30 and the EORTC-QLQ-BR-23 questionnaires were used to assess QoL before surgery, just after surgery, 6, 12 and 72 months later. The longitudinal effect of surgical modalities on QoL was assessed with a mixed model analysis of variance for repeated measurements.Results:Five hundred and eighteen BC patients were initially included. The median follow-up was 6 years. During the follow-up, 61 patients died. None of the patients of the SLNB group developed lymphedema during follow-up and the relapse rate was similar in the different groups (P=0.62). Before surgery, global health status (P=0.52) and arm symptoms (BRAS) (P=0.99) QoL scores were similar whatever the surgical procedure. The BRAS score (P=0.0001) was better in the SLNB group 72 months after surgery. Moreover, during follow-up, patients treated with SLNB had lower arm symptoms scores than ALND patients and there was no difference for arm symptoms between patients treated with ALND and those treated with SLNB followed by complementary ALND.Conclusion:Long-term follow-up showed that SLNB was associated with less morbidity than ALND.

SLNB improved GHS and BRAS QoL in breast cancer patients. However, surgeons must be cautious, SLNB with ALND results in a poorer QoL.

Sentinel lymph node biopsy has become routine practice in our Burgundy area. It is mainly dedicated to early stage breast cancer with limited metastatic risk. Our surgeons follow the most recent guidelines and indications are the same regardless of treatment centre.

The objective of this article is to explore the characteristics of older adults visiting the ED for suicidal thoughts and/or voluntary intoxication. MethodsAll older adults (65 years or older) who visited one of the five University Hospital Center (CHU) of Quebec EDs in 2016 and who reported suicidal thoughts or intoxication in triage or received a relevant discharge diagnosis were included. ResultsA total of 478 ED visits were identified, of which 332 ED visits (n=279 patients) were included. The mean age was 72.6 (standard deviation 6.8) years old and 41.6% were female. Mood disorders (41.2%) and alcoholism (40.5%) were common. Nearly 30% of all ED visits (n=109) resulted in a referral for a mental health assessment. In the subsequent year (2017), 38.4% returned to the ED for suicidal ideations. There were 7.9% who attended the ED five times or more. ConclusionsED visits for suicidal thoughts and intoxication in older adults are common among men with known mood disorders or alcoholism. ED dispositions are variable, and access to a mental health assessment is not consistent.

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