Persistent pain, sensory disturbances and functional impairment after immediate or delayed axillary lymph node...

Area of Science:

• Oncology
• Surgical Oncology
• Breast Cancer Research

Background:

• Two-step axillary lymph node dissection (ALND) may pose a higher risk of nerve damage and persistent pain after breast cancer treatment (PPBCT) compared to immediate ALND.
• Understanding the comparative risk of PPBCT and sensory disturbances is crucial for patient outcomes.

Purpose of the Study:

• To compare the prevalence and intensity of PPBCT, sensory disturbances, and functional impairment in patients undergoing a two-step ALND versus an immediate ALND after sentinel lymph node biopsy (SLNB) or ALND without prior SLNB.

Main Methods:

• Cross-sectional questionnaire study involving 2847 women treated with ALND between 2005-2008 in Denmark.
• Comparison of 196 patients with two-step ALND against 1558 patients with ALND after SLNB and 1093 patients with ALND without prior SLNB.

Main Results:

• High overall prevalence of PPBCT (55%) and sensory disturbances (77%) was observed across all groups.
• No statistically significant differences were found in the prevalence or intensity of PPBCT, sensory disturbances, or functional consequences between the two-step ALND group and the immediate ALND groups (p=0.92, p=0.32, p=0.35, respectively).

Conclusions:

• A two-step ALND approach does not alter the risk of developing persistent pain after breast cancer treatment when compared to an immediate ALND.
• Surgical approach for axillary staging in breast cancer does not appear to influence the likelihood of developing chronic pain or sensory deficits.