A Longitudinal Comparison of Arm Morbidity in Stage I–II Breast Cancer Patients Treated with Sentinel Lymph Node Biopsy, Sentinel Lymph Node Biopsy Followed by Completion Lymph Node Dissection, or Axillary Lymph Node Dissection
Identifieur interne : 005A78 ( Main/Exploration ); précédent : 005A77; suivant : 005A79A Longitudinal Comparison of Arm Morbidity in Stage I–II Breast Cancer Patients Treated with Sentinel Lymph Node Biopsy, Sentinel Lymph Node Biopsy Followed by Completion Lymph Node Dissection, or Axillary Lymph Node Dissection
Auteurs : Jan J. Kootstra [Pays-Bas] ; Josette E. H. M. Hoekstra-Weebers [Pays-Bas] ; Johan S. Rietman [Pays-Bas] ; Jakob De Vries [Pays-Bas] ; Peter C. Baas [Pays-Bas] ; Jan H. B. Geertzen [Pays-Bas] ; Harald J. Hoekstra [Pays-Bas]Source :
- Annals of Surgical Oncology [ 1068-9265 ] ; 2010.
Abstract
Long-term shoulder and arm function following sentinel lymph node biopsy (SLNB) may surpass that following complete axillary lymph node dissection (CLND) or axillary lymph node dissection (ALND). We objectively examined the morbidity and compared outcomes after SLNB, SLNB + CLND, and ALND in stage I/II breast cancer patients.
Breast cancer patients who had SLNB (
All outcomes changed significantly, mostly nonlinearly, over time (T0–T4). Between T1 and T4, limitations decreased in abduction (all groups); anteflexion, abduction-exorotation, abduction strength (SLNB + CLND, ALND); flexion strength (SLNB + CLND); and arm volume (SLNB, SLNB + CLND). At T4, limitations in anteflexion (SLNB, ALND), abduction (SLNB + CLND, ALND), exorotation (ALND), abduction-exorotation (all groups), and volume (SLNB + CLND, ALND) increased significantly compared with T0. The SLNB group showed an advantage in anteflexion, abduction, abduction-exorotation, and volume. Groups changed significantly but differently over time in anteflexion, abduction, abduction/exorotation, abduction strength, flexion strength, and volume. Effect sizes varied from 0.19 to 0.00.
Initial declines in range of motion and strength were followed by recovery, although not always to presurgery levels. Range of motion and volume outcomes were better for SLNB than ALND, but not strength. SLNB surpassed SLNB + CLND in 2 of the range of motion variables. The clinical relevance of these results is negligible.
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DOI: 10.1245/s10434-010-0981-8
PubMed: 20221902
PubMed Central: 2924495
Affiliations:
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Kootstra</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen</wicri:regionArea><placeName><settlement type="city">Groningue</settlement><region nuts="2" type="province">Groningue (province)</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of Surgery, Isala Klinieken, Zwolle, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgery, Isala Klinieken, Zwolle</wicri:regionArea><wicri:noRegion>Zwolle</wicri:noRegion></affiliation></author><author><name sortKey="Hoekstra Weebers, Josette E H M" sort="Hoekstra Weebers, Josette E H M" uniqKey="Hoekstra Weebers J" first="Josette E. H. M." last="Hoekstra-Weebers">Josette E. H. M. Hoekstra-Weebers</name><affiliation wicri:level="3"><nlm:aff id="Aff3">Wenckebach Institute, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Wenckebach Institute, University Medical Center Groningen, University of Groningen, Groningen</wicri:regionArea><placeName><settlement type="city">Groningue</settlement><region nuts="2" type="province">Groningue (province)</region></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff4">Comprehensive Cancer Center North-East, Groningen, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Comprehensive Cancer Center North-East, Groningen</wicri:regionArea><placeName><settlement type="city">Groningue</settlement><region nuts="2" type="province">Groningue (province)</region></placeName></affiliation><affiliation wicri:level="4"><nlm:aff id="Aff5">SHARE, Graduate School for Health Research, University of Groningen, Groningen, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>SHARE, Graduate School for Health Research, University of Groningen, Groningen</wicri:regionArea><placeName><settlement type="city">Groningue</settlement><region nuts="2" type="province">Groningue (province)</region><settlement type="city">Groningue (ville)</settlement></placeName><orgName type="university">Université de Groningue</orgName></affiliation></author><author><name sortKey="Rietman, Johan S" sort="Rietman, Johan S" uniqKey="Rietman J" first="Johan S." last="Rietman">Johan S. Rietman</name><affiliation wicri:level="1"><nlm:aff id="Aff6">Roessingh Research and Development, Enschede, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Roessingh Research and Development, Enschede</wicri:regionArea><wicri:noRegion>Enschede</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff7">Laboratory of Biomedical Engineering, Faculty of Engineering Technology, Twente University, Enschede, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Laboratory of Biomedical Engineering, Faculty of Engineering Technology, Twente University, Enschede</wicri:regionArea><wicri:noRegion>Enschede</wicri:noRegion></affiliation></author><author><name sortKey="De Vries, Jakob" sort="De Vries, Jakob" uniqKey="De Vries J" first="Jakob" last="De Vries">Jakob De Vries</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen</wicri:regionArea><placeName><settlement type="city">Groningue</settlement><region nuts="2" type="province">Groningue (province)</region></placeName></affiliation></author><author><name sortKey="Baas, Peter C" sort="Baas, Peter C" uniqKey="Baas P" first="Peter C." last="Baas">Peter C. Baas</name><affiliation wicri:level="3"><nlm:aff id="Aff8">Department of Surgery, Martini Hospital, Groningen, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgery, Martini Hospital, Groningen</wicri:regionArea><placeName><settlement type="city">Groningue</settlement><region nuts="2" type="province">Groningue (province)</region></placeName></affiliation></author><author><name sortKey="Geertzen, Jan H B" sort="Geertzen, Jan H B" uniqKey="Geertzen J" first="Jan H. B." last="Geertzen">Jan H. B. Geertzen</name><affiliation wicri:level="4"><nlm:aff id="Aff5">SHARE, Graduate School for Health Research, University of Groningen, Groningen, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>SHARE, Graduate School for Health Research, University of Groningen, Groningen</wicri:regionArea><placeName><settlement type="city">Groningue</settlement><region nuts="2" type="province">Groningue (province)</region><settlement type="city">Groningue (ville)</settlement></placeName><orgName type="university">Université de Groningue</orgName></affiliation><affiliation wicri:level="3"><nlm:aff id="Aff9">Department of Rehabilitation, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Rehabilitation, University Medical Centre Groningen, University of Groningen, Groningen</wicri:regionArea><placeName><settlement type="city">Groningue</settlement><region nuts="2" type="province">Groningue (province)</region></placeName></affiliation></author><author><name sortKey="Hoekstra, Harald J" sort="Hoekstra, Harald J" uniqKey="Hoekstra H" first="Harald J." last="Hoekstra">Harald J. Hoekstra</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen</wicri:regionArea><placeName><settlement type="city">Groningue</settlement><region nuts="2" type="province">Groningue (province)</region></placeName></affiliation></author></analytic><series><title level="j">Annals of Surgical Oncology</title><idno type="ISSN">1068-9265</idno><idno type="eISSN">1534-4681</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Long-term shoulder and arm function following sentinel lymph node biopsy (SLNB) may surpass that following complete axillary lymph node dissection (CLND) or axillary lymph node dissection (ALND). We objectively examined the morbidity and compared outcomes after SLNB, SLNB + CLND, and ALND in stage I/II breast cancer patients.</p></sec><sec><title>Materials and Methods</title><p>Breast cancer patients who had SLNB (<italic>n</italic> = 51), SLNB + CLND (<italic>n</italic> = 55), and ALND (<italic>n</italic> = 65) were physically examined 1 day before surgery (T0), and after 6 (T1), 26 (T2), 52 (T3), and 104 (T4) weeks. Differences in 8 parameters between the affected and unaffected arms were calculated. General linear models were computed to examine time, group, and interaction effects.</p></sec><sec><title>Results</title><p>All outcomes changed significantly, mostly nonlinearly, over time (T0–T4). Between T1 and T4, limitations decreased in abduction (all groups); anteflexion, abduction-exorotation, abduction strength (SLNB + CLND, ALND); flexion strength (SLNB + CLND); and arm volume (SLNB, SLNB + CLND). At T4, limitations in anteflexion (SLNB, ALND), abduction (SLNB + CLND, ALND), exorotation (ALND), abduction-exorotation (all groups), and volume (SLNB + CLND, ALND) increased significantly compared with T0. The SLNB group showed an advantage in anteflexion, abduction, abduction-exorotation, and volume. Groups changed significantly but differently over time in anteflexion, abduction, abduction/exorotation, abduction strength, flexion strength, and volume. Effect sizes varied from 0.19 to 0.00.</p></sec><sec><title>Conclusion</title><p>Initial declines in range of motion and strength were followed by recovery, although not always to presurgery levels. Range of motion and volume outcomes were better for SLNB than ALND, but not strength. SLNB surpassed SLNB + CLND in 2 of the range of motion variables. 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Malm</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Pays-Bas</li></country><region><li>Groningue (province)</li></region><settlement><li>Groningue</li><li>Groningue (ville)</li></settlement><orgName><li>Université de Groningue</li></orgName></list><tree><country name="Pays-Bas"><region name="Groningue (province)"><name sortKey="Kootstra, Jan J" sort="Kootstra, Jan J" uniqKey="Kootstra J" first="Jan J." last="Kootstra">Jan J. Kootstra</name></region><name sortKey="Baas, Peter C" sort="Baas, Peter C" uniqKey="Baas P" first="Peter C." last="Baas">Peter C. Baas</name><name sortKey="De Vries, Jakob" sort="De Vries, Jakob" uniqKey="De Vries J" first="Jakob" last="De Vries">Jakob De Vries</name><name sortKey="Geertzen, Jan H B" sort="Geertzen, Jan H B" uniqKey="Geertzen J" first="Jan H. B." last="Geertzen">Jan H. B. Geertzen</name><name sortKey="Geertzen, Jan H B" sort="Geertzen, Jan H B" uniqKey="Geertzen J" first="Jan H. B." last="Geertzen">Jan H. B. Geertzen</name><name sortKey="Hoekstra Weebers, Josette E H M" sort="Hoekstra Weebers, Josette E H M" uniqKey="Hoekstra Weebers J" first="Josette E. H. M." last="Hoekstra-Weebers">Josette E. H. M. Hoekstra-Weebers</name><name sortKey="Hoekstra Weebers, Josette E H M" sort="Hoekstra Weebers, Josette E H M" uniqKey="Hoekstra Weebers J" first="Josette E. H. M." last="Hoekstra-Weebers">Josette E. H. M. Hoekstra-Weebers</name><name sortKey="Hoekstra Weebers, Josette E H M" sort="Hoekstra Weebers, Josette E H M" uniqKey="Hoekstra Weebers J" first="Josette E. H. M." last="Hoekstra-Weebers">Josette E. H. M. Hoekstra-Weebers</name><name sortKey="Hoekstra, Harald J" sort="Hoekstra, Harald J" uniqKey="Hoekstra H" first="Harald J." last="Hoekstra">Harald J. Hoekstra</name><name sortKey="Kootstra, Jan J" sort="Kootstra, Jan J" uniqKey="Kootstra J" first="Jan J." last="Kootstra">Jan J. Kootstra</name><name sortKey="Rietman, Johan S" sort="Rietman, Johan S" uniqKey="Rietman J" first="Johan S." last="Rietman">Johan S. Rietman</name><name sortKey="Rietman, Johan S" sort="Rietman, Johan S" uniqKey="Rietman J" first="Johan S." last="Rietman">Johan S. Rietman</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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