The relative impact of the extent of axillary dissection and regional nodal irradiation on the development of arm edema in early stage breast cancer

Breast‐conserving therapy (BCT) for early‐stage breast cancer

“…The standard of axillary lymph node dissection in all patients with invasive breast cancer has come into question. The extent of axillary lymph node dissection is strongly correlated with the probability of arm edema [35,36] and is associated with breast edema. It is assumed that axillary lymph node dissection is also associated with illdefined complaints of arm and shoulder discomfort and dysfunction prevalent in BCT patients.…”

“…In experienced hands, it appears that the false negative rate of sentinel lymph node biopsy is extremely low, providing a rationale for omitting axillary lymph node dissection and regional lymph node irradiation in patients with negative sentinel lymph node biopsies. Approximately one half of cases of arm edema occur in patients whose lymph nodes are histologically negative and thus not irradiated [36]. If axillary dissection were performed in only patients with positive sentinel lymph node biopsies, the incidence of arm edema in patients with early-stage breast cancer could be significantly reduced.…”