Sensory morbidity after sentinel lymph node biopsy and axillary dissection: a prospective study of 233 women

We prospectively compared the sensory morbidity and lymphedema experienced after sentinel node biopsy (SLNB) and axillary dissection (ALND) over a 12-month period by using a validated instrument. Patients undergoing breast-conserving therapy completed the Breast Sensation Assessment Scale (BSAS) at...

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Bibliographic Details
Published in:Annals of surgical oncology 2002-08, Vol.9 (7), p.654-662
Main Authors: Temple, Larissa K F, Baron, Roberta, Cody, 3rd, Hiram S, Fey, Jane V, Thaler, Howard T, Borgen, Patrick I, Heerdt, Alexander S, Montgomery, Leslie L, Petrek, Jeanne A, Van Zee, Kimberly J
Format: Article
Language:English
Subjects:
Adult
Age Factors
Aged
Aged, 80 and over
Axilla
Breast Neoplasms - pathology
Female
Humans
Lymph Node Excision - adverse effects
Lymphedema - epidemiology
Lymphedema - etiology
Middle Aged
New York City - epidemiology
Prevalence
Prospective Studies
Sentinel Lymph Node Biopsy - adverse effects
Somatosensory Disorders - epidemiology
Somatosensory Disorders - etiology
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Summary:We prospectively compared the sensory morbidity and lymphedema experienced after sentinel node biopsy (SLNB) and axillary dissection (ALND) over a 12-month period by using a validated instrument. Patients undergoing breast-conserving therapy completed the Breast Sensation Assessment Scale (BSAS) at baseline and 3, 6, and 12 months after surgery. Repeated-measures analysis of variance was used to compare ALND and SLNB over the 12-month period. Upper- and lower-arm circumference measurements at baseline and 12 months were used to assess lymphedema. SLNB was associated with substantial sensory morbidity, although significantly less than ALND, over time on all four subscales and the summary score. A statistically significant improvement in sensory morbidity occurred for both groups in the first 3 months, with no further change thereafter. For both types of axillary surgery, younger patients had significantly higher BSAS scores than older patients. There was no significant difference in arm circumference between patients with SLNB and ALND at 12 months. Among women undergoing breast-conserving therapy, SLNB has significant sensory morbidity, although approximately half that of ALND. Sensory morbidity improves in the first 3 months after surgery, but patients continue to report sensory morbidity at 1 year. Longitudinal follow-up is required to further assess lymphedema.
ISSN:1068-9265
1534-4681
DOI:10.1007/BF02574481