The consequences of long-time arm morbidity in node-negative breast cancer patients with sentinel node biopsy or axillary clearance

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Abstract
Background The aim was to evaluate long-time morbidity in breast cancer patients 3 years after sentinel node biopsy (SNB) or axillary clearance (AC) emphasizing the consequences of morbidity like work-related events and the need of physiotherapy. Patients and Methods Morbidity was evaluated in 92 breast cancer patients 3 years after SNB only and in 47 patients after AC using a questionnaire. The circumferences of the upper extremities and the range of the shoulder movements were also measured. Results Two SNB and eight AC patients were not able to use the ipsilateral upper extremity to former extent P < 0.005. One SNB and one AC patient were retired or on a long-time sick leave because of arm morbidity. Clinically apparent upper extremity lymphoedema was observed in one SNB patient and in six AC patients, P < 0.005. Two SNB patients had received manual lymph drainage, one of them because of breast oedema. Seven patients had received manual lymph drainage after AC, three of them wore also compression sleeve, P < 0.05 between AC and SNB. Conclusions The risk of remarkable long-time arm morbidity after SNB is minimal. Work-related events seem uncommon due to arm morbidity, regardless of the extent of axillary surgery. J. Surg. Oncol. 2005;92:23–31.