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

Leidenius, Marjut; Leivonen, Marja; Vironen, Jaana; Smitten, Karl von

doi:10.1002/jso.20373

Cited by 122 publications

(94 citation statements)

References 19 publications

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“…Sener et al 19 defined postoperative arm volume differences of greater than 40% as severe lymphedema, but do not report its incidence. Others define it subjectively by patient report 2,5,8,13 or as the need to wear a compression garment. 20 To date, no series has reported severe lymphedema, as defined by arm measurements, in a patient after SLNB.…”

Section: Discussionmentioning

confidence: 99%

“…We identified only two published studies that included patients with a median follow-up of at least 2.5 years. 2,3 Furthermore, baseline measurements are essential to precisely determining changes in arm size resulting from lymphedema, as opposed to baseline asymmetry between dominant and nondominant arms. In addition, because the incidence of lymphedema is thought to be small after SLNB, evaluation of a large number of patients is essential to accurately estimate the prevalence.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of Lymphedema in Women With Breast Cancer 5 Years After Sentinel Lymph Node Biopsy or Axillary Dissection: Objective Measurements

McLaughlin

Wright

Morris

et al. 2008

JCO

547

347

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A B S T R A C T PurposeSentinel lymph node biopsy was adopted for the staging of the axilla with the assumption that it would reduce the risk of lymphedema in women with breast cancer. The aim of this study was to determine the long-term prevalence of lymphedema after SLN biopsy (SLNB) alone and after SLNB followed by axillary lymph node dissection (SLNB/ALND). Patients and MethodsAt median follow-up of 5 years, lymphedema was assessed in 936 women with clinically nodenegative breast cancer who underwent SLNB alone or SLNB/ALND. Standardized ipsilateral and contralateral measurements at baseline and follow-up were used to determine change in ipsilateral upper extremity circumference and to control for baseline asymmetry and weight change. Associations between lymphedema and potential risk factors were examined. ResultsOf the 936 women, 600 women (64%) underwent SLNB alone and 336 women (36%) underwent SLNB/ALND. Patients having SLNB alone were older than those having SLNB/ALND (56 v 52 years; P Ͻ .0001). Baseline body mass index (BMI) was similar in both groups. Arm circumference measurements documented lymphedema in 5% of SLNB alone patients, compared with 16% of SLNB/ALND patients (P Ͻ .0001). Risk factors associated with measured lymphedema were greater body weight (P Ͻ .0001), higher BMI (P Ͻ .0001), and infection (P Ͻ .0001) or injury (P ϭ .02) in the ipsilateral arm since surgery. ConclusionWhen compared with SLNB/ALND, SLNB alone results in a significantly lower rate of lymphedema 5 years postoperatively. However, even after SLNB alone, there remains a clinically relevant risk of lymphedema. Higher body weight, infection, and injury are significant risk factors for developing lymphedema.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prevalence of Lymphedema in Women With Breast Cancer 5 Years After Sentinel Lymph Node Biopsy or Axillary Dissection: Objective Measurements

McLaughlin

Wright

Morris

et al. 2008

JCO

547

347

View full text Add to dashboard Cite

show abstract

“…Existing studies indicate that patients who underwent an ALND, experience more pain [1,[4][5][6], numbness [1,[3][4][6][7], restricted range of shoulder motion [2][3][4][5][6], surgical complications [8], and have more lymph oedema [1][2][3], compared with patients who received a SLNB. Regarding health status, women reported more limitations in daily life after ALND [1][2]4], and they have less improvement of arm/shoulder mobility than the patients who only had SLNB [6]. However, no differences were found comparing depression and anxiety in SLNB and ALND patients during 1 year follow-up [2][3].…”

Section: Introductionmentioning

confidence: 99%

The relationship between morbidity after axillary surgery and long-term quality of life in breast cancer patients: The role of anxiety

Aerts¹,

Vries²,

Steeg³

et al. 2011

European Journal of Surgical Oncology

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. The relationship between morbidity after axillary surgery and long-term quality of life in breast cancer patients: The role of anxiety. EJSO -European Journal of Surgical Oncology, WB Saunders, 2011, 37 (4) This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Abstract AimsAlthough arm/shoulder morbidity after sentinel lymph node biopsy (SLNB) and/or axillary lymph node dissection (ALND) has been studied before, information is lacking concerning self-imposed restrictions in activities and long-term consequences of both surgical procedures in relationship to quality of life (QoL) and anxiety. MethodsEighty-nine disease-free breast cancer survivors completed a set of questionnaires assessing arm/shoulder symptoms, limitations in daily life, anxiety and QoL. Also, the ipsi-and contra lateral arm circumference and the range of shoulder motion were measured. ResultsFifty-one women had SLNB, 25 had SLNB followed by ALND and 13 had ALND. Although ALND patients experienced more shoulder symptoms, limitations in daily life and imposed more restrictions on themselves than SLNB patients, no significant differences during physical examination were found. A decreased range of motion and a higher score on trait anxiety resulted in a lower QoL. Trait anxiety and perceived limitations in daily life predicted long-term quality of life. ConclusionsThere is a discrepancy between experienced and measured limitations in range of shoulder motion. Anxiety and self-imposed restrictions play an important role in predicting long-term QoL and should get the necessary attention when addressing shoulder symptoms in breast cancer patients.

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“…However, it is associated with significant morbidity, including postoperative arm lymphedema and neuropathy of the involved extremity, and seroma formation in the axilla (Noguchi et al, 1997). Particularly, arm lymphedema develops in 7%-77% of patients who undergo axillary lymph node dissection (Blanchard et al, 2003;Leidenius et al, 2005;Haid et al, 2002;Mansel et al, 2006;Ronka et al, 2005;Schijven et al, 2003;Schrenk et al, 2000;Swenson et al, 2002). At present, sentinel lymph node biopsy is accepted as the standard method of surgical staging for axillary lymph nodes in breast cancer.…”

Section: Introductionmentioning

confidence: 99%

Axillary Reverse Mapping in Breast Cancer

Noguchi¹,

Yokoi²,

Nakano³

et al. 2011

Radioisotopes - Applications in Bio-Medical Science

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

Abstract: 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.

Cited by 122 publications

References 19 publications

Prevalence of Lymphedema in Women With Breast Cancer 5 Years After Sentinel Lymph Node Biopsy or Axillary Dissection: Objective Measurements

Prevalence of Lymphedema in Women With Breast Cancer 5 Years After Sentinel Lymph Node Biopsy or Axillary Dissection: Objective Measurements

The relationship between morbidity after axillary surgery and long-term quality of life in breast cancer patients: The role of anxiety

Axillary Reverse Mapping in Breast Cancer

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