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Complication Rates in Patients With Negative Axillary Nodes 10 Years After Local Breast Radiotherapy After Either Sentinel Lymph Node Dissection or Axillary Clearance
Journal article   Open access   Peer reviewed

Complication Rates in Patients With Negative Axillary Nodes 10 Years After Local Breast Radiotherapy After Either Sentinel Lymph Node Dissection or Axillary Clearance

A. Gabriella Wernicke, Michael Shamis, Kulbir K. Sidhu, Bruce C. Turner, Yevgenyia Goltser, Imraan Khan, Paul J. Christos and Lydia T. Komarnicky-Kocher
American journal of clinical oncology, v 36(1), pp 12-19
01 Feb 2013
DOI: https://doi.org/10.1097/COC.0b013e3182354bda
PMID: 22134519
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://europepmc.org/articles/pmc4064796View
Accepted (AM) Open Open Access (License Unspecified)

Abstract

Life Sciences & Biomedicine Oncology Science & Technology
Background: We assess complication rates in node negative breast cancer patients treated with breast radiotherapy (RT) only after sentinel lymph node dissection (SLND) or axillary lymph node dissection (ALND). Materials and Methods: Between 1995 and 2001, 226 women with AJCC stage I-II breast cancer were treated with lumpectomy, either SLND or SLND+ALND, and had available toxicities in follow-up: 111/136 (82%) and 115/129 (89%) in SLND and ALND groups, respectively. RT targeted the breast to median dose of 48.2 Gy (range, 46.0 to 50.4 Gy) without axillary RT. Chi-square tests compared complication rates of 2 groups for axillary web syndrome (AWS), seroma, wound infection, decreased range of motion of the ipsilateral shoulder, paresthesia, and lymphedema. Results: Median follow-up was 9.9 years (range, 8.3-15.3 y). Median number of nodes assessed was 2 (range, 1-5) in SLND and 18 (range, 7-36) in ALND (P < 0.0001). Acute complications occurred during the first 2 years and were AWS, seroma, and wound infection. Incidences of seroma 5/111 (4.5%) in SLND and 16/115 (13.9%) in ALND (P < 0.02, respectively) and wound infection 3/111 (2.7%) in SLND and 10/115 (8.7%) in ALND (P < 0.05, respectively) differed significantly. AWS was not statistically different between the groups. At 10 years, the only chronic complications decreased were range of motion of the shoulder 46/111 (41.4%) in SLND and 92/115 (80.0%) in ALND (P < 0.0001), paresthesia 12/111 (10.8%) in SLND and 39/115 (33.9%) in ALND (P < 0.0001), and lymphedema assessed by patients 10/111 (10.0%) in SLND and 39/115 (33.9%) in ALND (P < 0.0001). Chronic lymphedema, assessed by clinicians, occurred in 6/111 (5.4%) in SLND and 21/115 (18.3%) in ALND cohorts, respectively (P < 0.0001). Conclusions: Our mature findings support that in patients with negative axillary nodal status SLND and breast RT provide excellent long-term cure rates while avoiding morbidities associated with ALND or addition of axillary RT field.

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59 citations in Scopus

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Collaboration types
Domestic collaboration
Web of Science research areas
Oncology
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