Short‐term morbidity of the upper limb after sentinel lymph node biopsy or axillary lymph node dissection for Stage I or II breast carcinoma

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Abstract
BACKGROUND: The goals of sentinel lymph node biopsy (SLNB) are to improve axillary staging and reduce unnecessary axillary lymph node dissections (ALND), thereby reducing treatment‐related upper‐limb morbidity. In the current prospective study, short‐term upper‐limb morbidity was assessed after SLNB and/or ALND.METHODS: The study comprised 204 patients with Stage I/II breast carcinoma. Mean patient age was 55.6 years (standard deviation, 11.6). Sixty‐six patients (32%) underwent SLNB only, and 138 (68%) underwent a Level I–II ALND. Assessment (preoperative [t0] and 6 weeks postoperative [t1]) included evaluation of shoulder range of motion, muscle strength, grip strength, pain, upper/forearm circumference, shoulder disability, and activities of daily life (ADL).RESULTS: Considerable treatment‐related upper‐limb morbidity was observed. Significant (P < 0.001) changes were found for pain, range of motion in forward flexion, abduction and abduction/external rotation, strength of shoulder abductors and elbow flexors, and in perceived disability in ADL. However, no significant difference in change of upper‐limb function and ADL was found between the SLNB and ALND groups.CONCLUSIONS: Significant short‐term treatment‐related upper‐limb morbidity exists after SLNB or ALND. There is no significant difference in short‐term treatment‐related morbidity between SLNB and ALND. Cancer 2003;98:690–6. © 2003 American Cancer Society.DOI 10.1002/cncr.11545