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From the Department of Surgery (LKFT), Breast Service (RB, HSC, JVF, PIB, AH, LM, JAP, KJVZ), and the Department of Biostatistics (HTT), Memorial Sloan-Kettering Cancer Center, New York, New York.
Correspondence: Address correspondence and reprint requests to: Kimberly J. Van Zee, MS, MD, FACS, 1275 York Ave., MRI 1026, New York, NY 10021; Fax: 212-794-5812; E-mail: vanzeek{at}mskcc.org
Background: We prospectively compared the sensory morbidity and lymphedema experienced after sentinel node biopsy (SLNB) and axillary dissection (ALND) over a 12-month period by using a validated instrument.
Methods: Patients undergoing breast-conserving therapy completed the Breast Sensation Assessment Scale (BSAS) at baseline and 3, 6, and 12 months after surgery. Repeated-measures analysis of variance was used to compare ALND and SLNB over the 12-month period. Upper- and lower-arm circumference measurements at baseline and 12 months were used to assess lymphedema.
Results: SLNB was associated with substantial sensory morbidity, although significantly less than ALND, over time on all four subscales and the summary score. A statistically significant improvement in sensory morbidity occurred for both groups in the first 3 months, with no further change thereafter. For both types of axillary surgery, younger patients had significantly higher BSAS scores than older patients. There was no significant difference in arm circumference between patients with SLNB and ALND at 12 months.
Conclusions: Among women undergoing breast-conserving therapy, SLNB has significant sensory morbidity, although approximately half that of ALND. Sensory morbidity improves in the first 3 months after surgery, but patients continue to report sensory morbidity at 1 year. Longitudinal follow-up is required to further assess lymphedema.
Key Words: Sentinel lymph node biopsy • Axillary dissection • Morbidity • Breast cancer
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