Subjective morbidity and quality of life after sentinel node biopsy and axillary lymph node dissection for breast cancer

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Abstract
Background and Objectives Sentinel node (SN) biopsy is a minimally invasive surgical method for axillary staging in patients with breast cancer. The aim of this study was to evaluate mid-term morbidity after SN biopsy and axillary lymph node (ALN) dissection in patients with breast cancer receiving breast-sparing treatment, and to determine its impact on quality of life (QOL). Methods One hundred fifteen patients with breast cancer underwent breast-conserving treatment with SN biopsy alone (Group 1: n = 54), ALN dissection with or without SN biopsy (Group 2: n = 51), or SN biopsy followed by later ALN dissection (Group 3: n = 10). Results The mean post-operative follow-up was 20.3 months (range: 10–31 months) in Group 1, 24.3 months (range: 10–33 months) in Group 2, and 19.1 months (range: 12–28 months) in Group 3. Arm-shoulder pain was reported by 21.2% of patients in Group 1, 52.9% in Group 2, and 60% in Group 3 (P = 0.002). An arm swelling sensation was reported by 0% of patients in Group 1, 21.6% in Group 2, and 10% in Group 3. Dysesthesias were reported by 5.7% of patients in Group 1, 51% in Group 2, and 50% in Group 3 (P < 0.001). The mean global QOL self-rating score was 7.6 in Group 1, 7.6 in Group 2, and 7.7 in Group 3 (no significant difference). Conclusions SN biopsy is associated with significantly lower mid-term morbidity than ALN dissection. J. Surg. Oncol. 2005;92:17–22.