Incidence complications following sentinel lymph node biopsy or axillary lymph node dissection after breast cancer surgery.

Abstract

97 Background: To reduce arm morbidity the sentinel lymph node biopsy was implemented in the breast cancer treatment. The aim of this study was to investigate the arm morbidity after sentinel lymph node biopsy or axillary lymph node dissection. Methods: This is a prospective cohort study of women who underwent surgical treatment of breast cancer at a single institution. Arm and shoulder morbidity were measured before, 1 and 6 months after the operation. Analyses were performed to compare morbidity between sentinel lymph node biopsy (SLND) and axillary lymph node dissection (ALND). This study obtained approval from the National Cancer Institute research and ethics committee. Results: Were included 203 patients and, during the study, 6 were excluded and there was 23 losses of follow-up. The average age of women was 58 years (DP=13). SLND was made in 31,6% with an average of 3 lymph nodes removed. Among those submitted to ALND, the average lymph node removed was 18 (p<0.0001). After 45 days of surgery, the incidence of arm morbidity was: 23% of shoulder restriction (ALND 22%, SLND 1%, p<0.001); 28% of axillar web syndrome (ALND 24%, SLND 4%, p<0.001); 38% of seroma (ALND 32%, SLND 6%, p<0.001); 5% of arm edema (ALND 4%, SLND 1%, p<0.001). In the final evaluation occurred 6 months after the surgery, it was observed de following incidence: 4% of shoulder restriction (ALND 3%, SLND 1%, p=0.371); 18% of arm pain (ALND 12%, SLND 6%, p=0.460); 18% of axillar web syndrome (ALND 16%, SLND 2%, p<0.002); 5% of arm edema (ALND 4%, SLND 1%, p=0.417). Conclusions: After 45 days of surgery, patients with SLND has less arm morbidity compared with patients submitted to ALND. After 6 months, it was observed less incidence of arm symptoms and only axillary web syndrome were more incident in patients with axillary dissection.

Axillary surgery in breast cancer: acute postoperative complications in a hospital cohort of women of Rio de Janeiro, Brazil

“…The authors observed a 68% reduction in the risk of AWS among those who underwent SLNB as compared to AL 15 . A similar result was observed in another study conducted at the same institution with a population of 203 women also evaluated at 45 days (SLNB=4%, AL=24%, p<0.001) and 6 months (SLNB=2%, AL=16%, p<0.002) 14 .…”

“…Although the incidence of seroma in women submitted to SLNB (28.5%) was significantly lower compared to AL (69.4%), it was higher than those observed in European, American and Brazilian studies. In these cases, the incidence of seroma ranged from 1.8 to 14.0% in women submitted to SLNB, whereas in those submitted to AL, it ranged from 7.6 to 32.0% 14,[17][18][19][20][21] . Compared to the estimates observed in the literature, the high seroma incidence in the women of the present study could be due to differences on the seroma definition over the studies.…”

“…It is considered the preferred method of staging breast cancer in patients with clinically negative axilla with T1 or T2 classification 4,5 . Although some studies report the presence of early morbidities in women submitted to SLNB, the frequency is lower than in AL 6-8 . In Brazil, few studies have addressed the comparison of early complications according to the axillary approach, focusing mostly on AL [9][10][11] , while those describing the incidence in both axillary approach evaluated only a few complications [12][13][14][15][16] . Therefore, the aim of the present study is to estimate the risk of early postoperative complications according to the axillary surgical approach.…”

Metastatic status of sentinel lymph nodes in breast cancer determined with photoacoustic microscopy via dual-targeting nanoparticles

“…Moreover, subsequent histological analysis of LN metastasis after SLNB is time-consuming and somewhat subjective. In addition, SLN dissection may cause complications such as lymphedema, shoulder dysfunction and numbness 9,10 . Therefore, the development of a new approach to accurately identify LN metastases intraoperatively will help surgeons choose appropriate treatment plans with improved effects and minimise the complications caused by unnecessary LN removal.…”

Effective treatment of metastatic sentinel lymph nodes by dual-targeting melittin nanoparticles

“…However, due to the challenges of completely removing metastases with conventional surgery, especially the scattered microscopic foci that are easily missed, and the ineffectiveness of conventional chemotherapy delivery to metastatic regions, there exists a possibility for residual tumor tissue to further develop to distant metastases [ 7 , 8 ]. In addition, the adverse effects of SLN dissection, which include discomfort, lymphedema, and joint dyskinesia, may affect the patient’s quality of life [ 9 ]. Therefore, the development of novel methods to efficiently deliver therapeutics to the SLN, where tumors metastasize, could considerably suppress tumor growth and reduce mortality in cancer patients.…”