Complications of Level I and II Axillary Dissection in the Treatment of Carcinoma of the Breast

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Abstract
To assess the complications of level I and II axillary lymph node dissection in the treatment of stage I and II breast cancer, with breast-conservation surgery and mastectomy. The role of axillary dissection for staging, and as an effective means of controlling regional nodal disease, has long been recognized. As small and low-grade lesions have been detected more frequently, and as its therapeutic impact has been questioned, axillary dissection has increasingly been perceived as associated with significant complications. Two hundred patients, 112 of whom had breast-conservation surgery with axillary dissection and 88 of whom had total mastectomy with axillary dissection, were evaluated 1 year or more after surgery for arm swelling as well as nonedema complications. All patients had arm circumference measurements at the same four sites on both the operated and nonoperated sides. No patient had an axillary recurrence. The mean difference in circumference on the nonoperated versus operated side was 0.425 cm ± 1.39 at the midbiceps (p The characterization of a level I and II axillary dissection as a procedure with significant complications does not appear justified based on this experience.