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Arm morbidity after complete axillary lymph node dissection for breast cancer
P H A F Nagel1, E D M Bruggink, Th Wobbes
1Department of Surgery, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.
Acta Chirurgica Belgica
|May 29, 2003
Summary
Morbidity after axillary dissection for breast cancer is high, affecting arm sensation, shoulder function, and causing lymphedema. Adjuvant radiotherapy significantly increases these complications, necessitating careful consideration of its use.
Area of Science:
- Oncology
- Surgical Oncology
- Radiotherapy
Background:
- Axillary dissection is a common staging procedure for breast cancer.
- Understanding post-operative morbidity is crucial for patient quality of life.
Purpose of the Study:
- To identify factors influencing morbidity after axillary dissection in breast cancer patients.
- To assess the impact of lumpectomy versus mastectomy combined with axillary dissection.
Main Methods:
- Retrospective review of 106 invasive breast cancer patients' records (1996-1997).
- Objective assessment of lymphedema, shoulder mobility, and axillary sensation.
- Subjective assessment of arm morbidity and pain via questionnaire.
Main Results:
- High rates of morbidity observed: 13% lymphedema, 24% restricted shoulder function, 93% impaired axillary sensation.
- Adjuvant axillary radiation therapy significantly increased lymphedema and restricted shoulder function.
- Morbidity is substantial in a relatively young population undergoing staging procedures.
Conclusions:
- Axillary dissection leads to significant long-term morbidity.
- Adjuvant radiotherapy markedly exacerbates surgical morbidity.
- Individualized patient assessment is critical for deciding on adjuvant axillary radiotherapy to mitigate severe complications.