One-year morbidity after sentinel node biopsy and breast surgery

Area of Science:

• Oncology
• Surgical Oncology
• Clinical Outcomes Research

Background:

• Sentinel node biopsy (SNB) is a less invasive staging procedure for breast cancer compared to axillary clearance.
• Concerns exist regarding potential long-term morbidity following SNB, including arm lymphedema and functional impairment.

Purpose of the Study:

• To objectively evaluate and compare posttreatment morbidity within one year after sentinel node biopsy versus axillary clearance.
• To assess patient-reported symptoms and physical examination findings to determine the risk of severe long-term complications after SNB.

Main Methods:

• Prospective evaluation of patients undergoing either SNB or axillary clearance.
• Objective assessment via physical examination and subjective assessment through patient self-reported symptom questionnaires.
• Comparison of recovery trajectories and morbidity rates at 2 weeks and 1 year post-surgery.

Main Results:

• Patients undergoing SNB demonstrated significantly better recovery at 2 weeks post-surgery compared to those who had axillary clearance.
• Approximately one in four patients reported mild arm symptoms at 1 year after SNB.
• The risk of severe long-term morbidity, particularly disabling lymphedema, was found to be minimal following SNB alone.

Conclusions:

• Sentinel node biopsy is associated with a favorable short-term recovery profile and minimal risk of severe long-term morbidity.
• While mild arm symptoms can occur, they do not typically lead to significant disability.
• SNB represents a safe and effective alternative to axillary clearance for staging breast cancer, with negligible risk of disabling lymphedema.