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Comparison of Side Effects Between Sentinel Lymph Node and Axillary Lymph Node Dissection for Breast Cancer

From Park Nicollet Institute (KKS, MJN, LS, MWL, TMT), Minneapolis, Minnesota; The Breast Center of United Hospital (CC), St. Paul, Minnesota; and the University of Minnesota Division of Surgical Oncology (TMT), Minneapolis, Minnesota.

Correspondence: Address correspondence and reprint requests to: Karen K. Swenson, RN, MS, AOCN, Park Nicollet Institute, 3800 Park Nicollet Blvd., Minneapolis, MN 55416; Fax: 952-993-5235; E-mail: swensk{at}parknicollet.com

Background: Axillary lymph node dissection (ALND) is often associated with permanent arm side effects. Side effects after sentinel lymph node dissection (SLND) should be less common, because the surgery is less extensive.

Methods: The study compared side effects and interference with daily life between 169 women who underwent an SLND and 78 who underwent an ALND for breast cancer. Patients rated symptom severity and interference with daily life caused by pain, numbness, limitation of arm range of motion (ROM), and arm swelling at 1, 6, and 12 months after surgery by using the Measure of Arm Symptom Survey. Repeated-measures and regression analyses for each time period were used to determine associations between symptoms and dissection type.

Results: At 1 month, SLND patients reported less pain, numbness, limitation in ROM, and seromas than ALND patients. At 6 months, SLND patients had less pain, numbness, and arm swelling, and at 12 months, SLND patients had less numbness, arm swelling, and limitation in ROM than ALND patients. At 1 month, pain, numbness, and limitation in ROM interfered significantly more with daily life for ALND patients. At 6 and 12 months, only numbness interfered more with daily life for ALND patients.

Conclusions: SLND was associated with fewer side effects than ALND at all time points.

Key Words: Breast cancer • Surgery • Axilla • Sentinel lymph node • Arm side effects

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