Takamaru Ashikaga1, David N. Krag1, Stephanie R. Land2,3, Thomas B. Julian2,3, Stewart Anderson2, Ann Brown2, Joan M. Skelly1, Seth P. Harlow1, Donald L. Weaver1, Eleftherios P. Mamounas4, Joseph P. Costantino2, Norman Wolmark5,3
1University of Vermont College of Medicine, Burlington, Vermont
2Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
3National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, Pennsylvania
4Aultman Health Foundation, Canton, Ohio
5Allegheny General Hospital, Pittsburgh, Pennsylvania.
Tóm tắt
AbstractBackground and ObjectivesThree year post‐surgical morbidity levels were compared between patients with negative sentinel lymph node dissection alone (SLND) and those with negative sentinel node dissection and negative axillary lymph node dissection (ALND) in the NSABP B‐32 trial.MethodsA total of 1,975 ALND and 2,008 SLND node negative breast cancer patients had shoulder range of motion and arm volumes assessed along with self reports of arm tingling and numbness. Relative shoulder abduction deficits and relative arm volume differences between ipsilateral and contralateral arms were calculated.ResultsShoulder abduction deficits ≥10% peaked at 1 week for the ALND (75%) and SLND (41%) groups. Arm volume differences ≥10% at 36 months were evident for the ALND (14%) and SLND (8%) groups. Numbness and tingling peaked at 6 months for the ALND (49%, 23%) and SLND (15%, 10%) groups. Logistic regression correlates of residual morbidity included treatment group, age, handedness, tumor size, systemic chemotherapy, and radiation to the axilla.ConclusionsAlthough residual morbidity for both treatment groups was evident, the results of the NSABP B‐32 study indicate the superiority of the SLND compared to the ALND treatment approach relative to post‐surgical morbidity outcomes over a 3‐year follow‐up period. J. Surg. Oncol. 2010;102:111–118. © 2010 Wiley‐Liss, Inc.
