Eighteen Sensations After Breast Cancer Surgery: A 5-Year Comparison of Sentinel Lymph Node Biopsy and Axillary Lymph Node Dissection

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Abstract
The aim of this study is to evaluate prevalence, severity, and level of distress of 18 sensations at baseline (3–15 days) and 5 years after breast cancer surgery, and compare sensations after sentinel lymph node biopsy (SLNB) with those after SLNB plus immediate or delayed axillary lymph node dissection (ALND). A total of 187 patients with breast cancer completed the Breast Sensation Assessment Scale at baseline and at 3, 6, 12, 24, and 60 months after surgery to assess prevalence, severity, and level of distress of sensations. Of these, 133 had SLNB, and 54 had SLNB and ALND. Additionally, of the 187 patients, 141 had breast-conservation therapy and 46 had total mastectomy. Sensations were less prevalent, severe, and distressing after SLNB compared with ALND at baseline and at 5 years. This difference was most evident in those who had breast-conservation therapy. Most sensations after SLNB and ALND, even if prevalent, were not severe or distressing. Some sensations remained notably prevalent at 5 years, including tenderness and twinges after SLNB, and tightness and numbness after ALND. Phantom sensations were frequently reported by mastectomy patients. Prevalence, severity, and level of distress of sensations were lower after SLNB compared with ALND, but some morbidity existed after SLNB. Certain sensations remained highly prevalent in both groups for up to 5 years.