Prospective evaluation of the morbidity of axillary clearance for breast cancer

Duff, M. J.; Hill, A. D. K.; McGreal, G.; Walsh, Stewart R.; McDermott, Enda; O’Higgins, N.

doi:10.1046/j.1365-2168.2001.01620.x

Cited by 52 publications

(45 citation statements)

References 18 publications

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“…1,2,17 Few studies have compared physical morbidity of ALDN with SNB reflecting the impact of both techniques on the patient's quality-of-life. 16 The present study focuses on frequency and severity of selfreported physical complaints and problems in daily life among breast cancer patients having had different surgical approaches to the axilla.…”

Section: ±13mentioning

confidence: 99%

Comparison of morbidity between axillary lymph node dissection and sentinel node biopsy

Schijven¹,

Vingerhoets²,

Rutten³

et al. 2003

European Journal of Surgical Oncology (EJSO)

255

125

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Comparison of morbidity between axillary lymph node dissection and sentinel node biopsy Schijven, M.; Vingerhoets, Ad; Rutten, H.J.T.; Nieuwenhuijzen, G.A.P.; Roumen, R.M.H.; Bussel, M.E.; Voogd, A.C. General rightsCopyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.-Users may download and print one copy of any publication from the public portal for the purpose of private study or research -You may not further distribute the material or use it for any profit-making activity or commercial gain -You may freely distribute the URL identifying the publication in the public portal Take down policy If you believe that this document breaches copyright, please contact us providing details, and we will remove access to the work immediately and investigate your claim.Download date: 12. mei. 2018 EJSO 2003; 29: 341±350 doi:10.1053/ejso.2002.1385 Comparison of morbidity between axillary lymph node dissection and sentinel node biopsy Aims: The use of axillary lymph node dissection (ALND) in women with breast cancer is associated with considerable morbidity. Sentinel node biopsy (SNB) removes the lymph node in the axillary basin indicative for receiving first lymphatic drainage from the breast. This study compares the nature and severity of physical morbidity among breast cancer patients who underwent primary surgery for breast cancer combined with either ALND or SNB. Also, it assesses influence of subsequent radiotherapy on morbidity. Method: Two hundred and thirteen ALND patients were compared with 180 SNB patients retrospectively. Morbidity was measured using a disease-specific quality-of-life questionnaire. Results: Patients' demographic characteristics were alike. The axillary procedure is the strongest and most consistent factor in explaining differences in a variety of self-reported complaints. Patients having had SNB have a 3.2-fold lower risk of experiencing pain, a 5-fold lower risk of lymph oedema, a 7.7-fold lower risk of numbness, a 3.7-fold lower risk of tingling sensations, a 7.1-fold lower risk of loss of strength in arm/hand, a 3.6-fold lower risk of loss of active motion range of the arm and a 2.9-fold lower risk of impaired use of the arm. Axillary radiation therapy adds to complaints next to the axillary surgical procedure by increasing the risk of lymph oedema 2.4-fold and enhancing the risk of impaired use of the arm by 2.6-fold. Axillary radiation therapy does not explain lymph oedema by itself. Conclusion: SNB is associated with less morbidity compared to ALND in patients with primary breast cancer.

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Section: ±13mentioning

confidence: 99%

Comparison of morbidity between axillary lymph node dissection and sentinel node biopsy

Schijven¹,

Vingerhoets²,

Rutten³

et al. 2003

European Journal of Surgical Oncology (EJSO)

255

125

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“…heaviness, aching, swelling, loss of function), 16,17 objective measurement (using an array of measurement tools and protocols) [18][19][20] and a combination of the self-re-port and objective measures. [21][22][23][24] The evaluation method-ology is likely to affect incidence findings as recent studies using multiple methods have indicated greater subjective reporting of symptoms compared with objective measurement classification of BCRL. 22,25 The multifaceted nature of morbidity resulting from BCRL, across physical, functional, social and psychological domains, indicates that a multi-dimensional assessment methodology including subjective and objective findings is likely to provide optimal validity.…”

Section: Breast Cancer-related Lymphoedemamentioning

confidence: 99%

Breast cancer-related lymphoedema risk reduction advice: A challenge for health professionals

Nielsen

Gordon

Selby

2008

Cancer Treatment Reviews

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SummaryBreast cancer-related lymphoedema (BCRL) is a debilitating, distressing condition affecting approximately one in five breast cancer survivors (Clark B, Sitzia J, Harlow W. Incidence and risk of arm oedema following treatment for breast cancer: a three-year follow-up study. QJM 2005;98:343-8). The evidence-base for breast cancer-related lymphoedema risk reduction advice is scant and contradictory, with most studies in the area limited by small numbers, retrospective design and other methodological inadequacies. Current advice has the capacity to profoundly alter quality of life following treatment for breast cancer. Health professionals should review the risk reduction advice they provide to reflect the current understanding of aetiology and risk factors. Further research is required to provide more evidence for the content, to identify optimal methods of precautionary education delivery and to determine the effect of the advice on the patient's quality of life and perception of recovery.

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“…Traditionally, axillary dissection at the time of mastectomy or breast conservation surgery is the method for obtaining this information regarding the histological nodal status of the patient. Axillary dissection is commonly associated with morbidity (Ivens et al, 1992;Duff et al, 2001), and patients who are node negative derive no benefit from it, hence the recent interest in less invasive staging procedures such as sentinel node biopsy and axillary node sampling. The aim of imaging would be to identify patients with nodal metastases for whom axillary node clearance would be appropriate.…”

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confidence: 99%

Diagnosis of axillary nodal metastases by ultrasound-guided core biopsy in primary operable breast cancer

et al. 2003

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The purpose of this study was to examine the use of ultrasound (US)-guided core biopsy of axillary nodes in patients with operable breast cancer. The ipsilateral axillae of 187 patients with suspected primary operable breast cancer were scanned. Nodes were classified based on their shape and cortical morphology. Abnormal nodes underwent US-guided core biopsy/fine needle aspiration (FNA), and the results correlated with subsequent axillary surgery. The nodes were identified on US in 103 of 166 axillae of patients with confirmed invasive carcinoma. In total, 54 (52%) met the criteria for biopsy: 48 core biopsies (26 malignant, 20 benign node, two normal) and six FNA were performed. On subsequent definitive histological examination, 64 of 166 (39%) had axillary metastases. Of the 64 patients with involved nodes at surgery, preoperative US identified nodes in 46 patients (72%), of which 35 (55%) met the criteria for biopsy and 27 (42%) of these were diagnosed preoperatively by US-guided biopsy. In conclusion, US can identify abnormal nodes in patients presenting with primary operable breast cancer. In all, 65% of these nodes are malignant and this can often be confirmed with US-guided core biopsy.

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Prospective evaluation of the morbidity of axillary clearance for breast cancer

Abstract: This study provided accurate documentation of the morbidity associated with axillary clearance, together with a reproducible method of arm volume measurement.

Cited by 52 publications

References 18 publications

Comparison of morbidity between axillary lymph node dissection and sentinel node biopsy

Comparison of morbidity between axillary lymph node dissection and sentinel node biopsy

Breast cancer-related lymphoedema risk reduction advice: A challenge for health professionals

Diagnosis of axillary nodal metastases by ultrasound-guided core biopsy in primary operable breast cancer

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