Axillary Lymph Node Dissection for Breast Cancer: Efficacy and Complication in Developing Countries

Abstract

PurposeAxillary lymph node dissection (ALND) frequently is performed as part of the surgical management of breast cancer as a therapeutic and prognostic index, but increasingly has been perceived as associated with significant complications. Data on efficacy and complications of ALND in Sudan are lacking. The aim of this study was to assess the efficacy and complications of ALND in patients with breast cancer treated with mastectomy and breast-conserving surgery.MethodsWe performed a prospective, hospital-based study in women with invasive breast cancer who underwent modified radical mastectomy or breast-conserving surgery with ALND between September 2014 and August 2015. The efficacy of ALND was defined as retrieval of ≥ 10 lymph nodes. Complications of ALND were assessed objectively and subjectively and defined as either present or absent.ResultsOf 96 patients with breast cancer included in the study, 40 (42%) developed postaxillary clearance complications. The median follow-up time was 18 months (range, 12 to 24 months). Numbness was reported by 21.9% of patients. Seroma was noted in 15.6% and lymphedema in 9.4%. Approximately 9% reported episodes of infection or inflammation at the surgical site. None of the studied factors were found to affect the incidence of complications significantly. Ten or more lymph nodes were retrieved in 81.3% of patients, and nodal metastasis was found in 62.5%.ConclusionThis study shows that the prevalence of undesirable adverse effects after ALND is 42%, with paresthesia and seroma being the most prevalent. The lymphedema prevalence was low in relation to other evaluated symptoms.

Early Complications After Radical Operations in Breast Cancer Patients

“…M.O. Abass et al (2018) reported what seroma after RME with LND was detected in 15.6 % of cases [6]. In another study, the rate of seroma was dependent from the use of a hemostasis device: 37.5 % of patients were using standard electrosurgical device, while using a new electrosurgical device (PEAK PlasmaBlade) -in 10 % [14].…”

“…[13]. M. O. Abass et al (2018) reported about complications in 42 % of women after similar surgery [6].…”

“…In addition to extensive tissue removal of the mammary gland, radical surgery is facilitated by lymph node dissection (LND) in the areas of potential metastasis, which leads to damage to the elements of lymphatic outflow and is one of the leading causes of complications of early and late postoperative period [4,5]. In the early period after surgery, the most common complications are the formation of lymphocele (seroma), lymphorrhea, postoperative edema, wound infections and impaired wound healing [6,7], whose frequency increases during reconstructive operations especially using autoplastic methods [8]. The most common complication is seroma, the frequency of which reaches 85 %.…”

Risk factors and prevention of postmastectomic syndrome in breast cancer surgery

“…Abass та співавт (2018), після аналогічних операцій лімфедему виявлено у 9,4 % пацієнток. [9], а за даними L. Zou та співавт. (2018) після операції частота лімфедеми сягала 28,6 %, а через 2 роки -32,5 % [6].…”

A case of transient telangiectatic purpura after axillary dissection

“…Complications after ALND are well known and include wound infection, seroma, hematoma, lymphedema of the arm, lymphangitis, arm numbness, pain syndromes, limitation of arm movement, and paresthesia (Abass, Gismalla, Alsheikh, & Elhassan, 2018). Forty-five days after surgery the patient came to our attention because she had developed a purple telangiectatic rash with areas of purpura spreading to the right hemithorax, involving the contralateral breast and reaching to the posterior of the right scapula.…”