Shoulder–arm morbidity following axillary dissection and sentinel node only biopsy for breast cancer

Haid, A.; Kuehn, Thorsten; Kempler, Péter; Köberle-Wührer, Roswitha; Knauer, Michael; Kreienberg, R.; Zimmermann, G.

doi:10.1053/ejso.2002.1327

Cited by 110 publications

(70 citation statements)

References 21 publications

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“…[9][10][11] An increasing number of studies reported EJSO 32 (2006) less treatment related morbidity for SLNB in comparison to ALND. [12][13][14][15][16][17][18][19][20] Generally disability in ADL of the SLNB group was less than that of the ALND group. 13,16,19 A shortcoming in most studies is the absence of pretreatment assessment and the absent of reliable and validated assessment instruments.…”

Section: Introductionmentioning

confidence: 87%

Long term treatment related upper limb morbidity and quality of life after sentinel lymph node biopsy for stage I or II breast cancer

Rietman

Geertzen

Hoekstra

et al. 2006

European Journal of Surgical Oncology (EJSO)

131

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Long term treatment related upper limb morbidity and quality of life after sentinel lymph node biopsy for stage I or II breast cancer Rietman, J.S.; Geertzen, J.H.B.; Hoekstra, H.J.; Baas, P.; Dolsma, W.V.; de Vries, J; Groothoff, J.W.; Eisma, W.H.; Dijkstra, P.U. AbstractBackground: In a prospective study, long term upper-limb morbidity, perceived disabilities in activities of daily life (ADL) and quality of life (QOL) were assessed before and 2 years after sentinel lymph node biopsy (SLNB) or axillary lymph node dissections (ALND) for breast cancer. Methods: Two hundred and four patients with stage I/II breast cancer, mean age 55.6 years (SD: 11.6) entered the study and 181 patients (89%) could be evaluated after 2 years. Fifty-seven patients underwent SLNB (31%) and 124 patients underwent an ALND (69%). Assessments included pain, shoulder range of motion, muscle strength, arm volume, perceived shoulder disability in ADL and QOL. Results: Significant (P!0.05) changes between before and 2 years after surgery were found in almost all assessments of shoulder function, ADL and several QOL subscales. Patients in the ALND group showed significant more changes in range of motion (ROM), grip strength, arm volume, ADL and QOL physical-and role functioning, pain and sleeplessness and arm symptoms compared to the SLNB group. Multivariate linear regression analysis showed that ALND could predict decrease of ROM, grip strength, ADL and physical functioning (QOL) and increase of arm volume, pain and arm symptoms score (QOL). Radiation on the axilla predicts an additional decrease in shoulder ROM and increase of arm volume. Conclusion: Two years after surgery for breast cancer, patients show significantly less treatment related upper limb morbidity, perceived disability in ADL and worsening of QOL after SLNB compared with ALND. q

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Section: Introductionmentioning

confidence: 87%

Long term treatment related upper limb morbidity and quality of life after sentinel lymph node biopsy for stage I or II breast cancer

Rietman

Geertzen

Hoekstra

et al. 2006

European Journal of Surgical Oncology (EJSO)

131

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“…At the same evaluation, the circumference of the treated arm was measured (treated arm 15 cm above the lateral epicondyle) and compared with that of the contralateral arm. [28][29][30][31][32][33] …”

Section: Statistical Analysesmentioning

confidence: 99%

Comparison of Mastoscopic and Conventional Axillary Lymph Node Dissection in Breast Cancer: Long-term Results From a Randomized, Multicenter Trial

Luo

Guo

Yang

et al. 2012

Mayo Clinic Proceedings

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Objective: To compare the long-term results of mastoscopic axillary lymph node dissection (MALND) and conventional axillary lymph node dissection (CALND). Patients and Methods: From January 1, 2003, through December 31, 2005, a group of 1027 consecutive patients with operable breast cancer were randomly assigned to 1 of 2 study groups: MALND and CALND. The median follow-up was 63 months. The primary end points of the study were operative outcomes, complication reduction, function conservation, and cosmetics. The secondary end points were disease-free and overall survival. Results: The mean operative blood loss in the MALND group was less than in the CALND group (PϽ.001). The patients who underwent MALND had less axillary pain, numbness or paresthesias, and arm swelling (PϽ.001). The aesthetic appearance of the axilla in the MALND group was much better than that in the CALND group (Pϭ.001 at 6 months and Pϭ.002 at 24 months). A significant difference was found between the 2 groups in distant metastasis (Pϭ.04). The disease-free survival rate was 64.5% in the MALND group and 60.8% in the CALND group (Pϭ.88). The overall survival rate was 81.7% in the MALND group and 78.6% in the CALND group (Pϭ.95).

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“…The technique of sentinel lymph node biopsy (SLNB) has reduced the morbidity of axillary staging for breast cancer, but is still associated with a smaller but significant risk of paresthesias, 1,2 limited shoulder mobility, [3][4][5] and lymphedema.…”

Section: Introductionmentioning

confidence: 99%

“…Existing series quantifying lymphedema after SLNB have used circumferential arm measurements, 6-9 patient questionnaires, 4,[10][11][12] or both 3,[13][14][15][16][17][18][19][20] to document its presence. The reported rates of lymphedema may be influenced by each patient's interpretation of their own arm swelling and concomitantly by existing sensory changes.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Lymphedema in Women With Breast Cancer 5 Years After Sentinel Lymph Node Biopsy or Axillary Dissection: Patient Perceptions and Precautionary Behaviors

McLaughlin

Wright

Morris

et al. 2008

JCO

197

115

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A B S T R A C T PurposeSentinel lymph node (SLN) biopsy was adopted for the staging of the axilla with the assumption that it would reduce the risk of lymphedema in women with breast cancer. This study was undertaken to examine patient perceptions of lymphedema and use of precautionary behaviors several years after axillary surgery. Patients and MethodsNine hundred thirty-six women who underwent SLN biopsy (SLNB) alone or SLNB followed by axillary lymph node dissection (SLNB/ALND) between June 1, 1999, and May 30, 2003, were evaluated at a median of 5 years after surgery. Patient-perceived lymphedema and avoidant behaviors were assessed through interview and administered a validated instrument, and compared with arm measurements. ResultsCurrent arm swelling was reported in 3% of patients who received SLNB alone versus 27% of patients who received SLNB/ALND (P Ͻ .0001), as compared with 5% and 16%, respectively, with measured lymphedema. Only 41% of patients reporting arm swelling had measured lymphedema, and 5% of patients reporting no arm swelling had measured lymphedema. Risk factors associated with reported arm swelling were greater body weight (P Ͻ .0001), higher body mass index (P Ͻ .0001), infection (P Ͻ .0001), and injury (P ϭ .007) in the ipsilateral arm since surgery. Patients followed more precautions if they had measured or perceived lymphedema. ConclusionBody weight, infection, and injury are significant risk factors for perceiving lymphedema. There is significant discordance between the presence of measured and patient-perceived lymphedema. When compared to SLNB/ALND, SLNB-alone results in a significantly lower rate of patientperceived arm swelling 5 years postoperatively, and is perceived by fewer women than are measured to have it. J Clin

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Shoulder–arm morbidity following axillary dissection and sentinel node only biopsy for breast cancer

Cited by 110 publications

References 21 publications

Long term treatment related upper limb morbidity and quality of life after sentinel lymph node biopsy for stage I or II breast cancer

Long term treatment related upper limb morbidity and quality of life after sentinel lymph node biopsy for stage I or II breast cancer

Comparison of Mastoscopic and Conventional Axillary Lymph Node Dissection in Breast Cancer: Long-term Results From a Randomized, Multicenter Trial

Prevalence of Lymphedema in Women With Breast Cancer 5 Years After Sentinel Lymph Node Biopsy or Axillary Dissection: Patient Perceptions and Precautionary Behaviors

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