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Morbidity results from the NSABP B‐32 trial comparing sentinel lymph node dissection versus axillary dissection
Author(s) -
Ashikaga Takamaru,
Krag David N.,
Land Stephanie R.,
Julian Thomas B.,
Anderson Stewart J.,
Brown Ann M.,
Skelly Joan M.,
Harlow Seth P.,
Weaver Donald L.,
Mamounas Eleftherios P.,
Costantino Joseph P.,
Wolmark Norman
Publication year - 2010
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21535
Subject(s) - medicine , axillary lymph node dissection , axilla , breast cancer , surgery , sentinel lymph node , dissection (medical) , lymph node , lymphedema , cancer
Background and Objectives Three year post‐surgical morbidity levels were compared between patients with negative sentinel lymph node dissection alone (SLND) and those with negative sentinel node dissection and negative axillary lymph node dissection (ALND) in the NSABP B‐32 trial. Methods A total of 1,975 ALND and 2,008 SLND node negative breast cancer patients had shoulder range of motion and arm volumes assessed along with self reports of arm tingling and numbness. Relative shoulder abduction deficits and relative arm volume differences between ipsilateral and contralateral arms were calculated. Results Shoulder abduction deficits ≥10% peaked at 1 week for the ALND (75%) and SLND (41%) groups. Arm volume differences ≥10% at 36 months were evident for the ALND (14%) and SLND (8%) groups. Numbness and tingling peaked at 6 months for the ALND (49%, 23%) and SLND (15%, 10%) groups. Logistic regression correlates of residual morbidity included treatment group, age, handedness, tumor size, systemic chemotherapy, and radiation to the axilla. Conclusions Although residual morbidity for both treatment groups was evident, the results of the NSABP B‐32 study indicate the superiority of the SLND compared to the ALND treatment approach relative to post‐surgical morbidity outcomes over a 3‐year follow‐up period. J. Surg. Oncol. 2010;102:111–118. © 2010 Wiley‐Liss, Inc.