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Single-port Non-liposuction Endoscopic Axillary Lymph Node Dissection in Breast Cancer Surgery
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Short- and long-term recovery of upper limb function after axillary lymph node dissection
N Devoogdt1, M Van Kampen, M R Christiaens
1Department of Physiotherapy - University Hospitals Leuven, Leuven, Belgium. nele.devoogdt@artesis.be
European Journal of Cancer Care
|August 28, 2009
Summary
Breast cancer surgery involving axillary lymph node dissection can lead to long-term shoulder mobility issues, lymphoedema, pain, and daily activity challenges for survivors.
Area of Science:
- Oncology
- Surgical Oncology
- Rehabilitation Medicine
Background:
- Axillary lymph node dissection is a standard procedure for breast cancer patients with suspected lymph node invasion.
- The impact of this surgery on patients' quality of life, including shoulder function and lymphedema, requires thorough investigation.
Purpose of the Study:
- To evaluate the short- and long-term effects of breast cancer treatment, including axillary lymph node dissection, on shoulder mobility, lymphedema development, pain, and daily activities.
- To compare outcomes between modified radical mastectomy and breast-conserving procedures in conjunction with axillary lymph node dissection.
Main Methods:
- A cohort of breast cancer patients undergoing modified radical mastectomy (33%) or breast-conserving surgery (67%) with axillary lymph node dissection were included.
- Shoulder mobility, lymphedema, pain, and activities of daily living were assessed at 3 months and 3.4 years post-surgery.
Main Results:
- Long-term follow-up (3.4 years) revealed persistent issues: 31% had impaired shoulder mobility, 18% developed lymphedema, 79% experienced pain, and 51% reported difficulties with daily activities.
- Between 3 months and 3.4 years, shoulder mobility improved (57% to 31%), while lymphedema incidence increased (4% to 18%). Pain levels remained stable, and daily activity problems decreased.
- No significant differences in long-term outcomes were observed between mastectomy and breast-conserving procedures.
Conclusions:
- A substantial proportion of breast cancer survivors experience long-term sequelae, including impaired shoulder mobility, lymphedema, pain, and functional limitations.
- While shoulder mobility, pain, and daily activities show improvement over time, the incidence of lymphedema increases post-surgery.
- The type of breast surgery (mastectomy vs. breast-conserving) did not significantly impact these long-term functional outcomes.
