[Complications following axillary dissection for breast carcinoma].
Identifieur interne : 00CB96 ( Main/Exploration ); précédent : 00CB95; suivant : 00CB97[Complications following axillary dissection for breast carcinoma].
Auteurs : M S Van Dam [Pays-Bas] ; A. Hennipman ; J T De Kruif ; I. Van Der Tweel ; P W De GraafSource :
- Nederlands tijdschrift voor geneeskunde [ 0028-2162 ] ; 1993.
Descripteurs français
- KwdFr :
- MESH :
English descriptors
- KwdEn :
- MESH :
- etiology : Lymphedema, Postoperative Complications, Surgical Wound Infection.
- methods : Mastectomy.
- Adult, Aged, Aged, 80 and over, Female, Humans, Mastectomy, Radical, Mastectomy, Segmental, Middle Aged, Necrosis, Pain, Postoperative.
Abstract
Axillary dissection in breast cancer is performed to stage the tumor and to obtain regional tumour control. It is associated with some morbidity. Recently mention was made of post-axillary dissection pain of the arm following damage to one or more of the intercostobrachial nerves. In the University Hospital of Utrecht a radical axillary dissection is routinely performed for breast cancer with transection of the sensory intercostobrachial nerve(s). To evaluate the inherent morbidity of this operation, we interviewed and examined 71 women (75 axillae) who had undergone an axillary dissection for carcinoma of the breast between January 1987 and January 1990. In almost all cases a sensory deficit was present in the axilla and/or arm. In 23 patients (26 sides; 35%) there was pain in the arm, always in the innervation area of the intercostobrachial nerves. One-third of these cases had a NRS score of 5 or higher, indicating moderate to severe pain. Seroma and lymphedema were found in 21 patients. In 6 shoulders abduction was reduced to 90 degrees. The several complaints were non-invalidating to 48 patients, slightly invalidating to 13 and moderately invalidating to 10 patients. At present, histological examination of the axillary nodes is still the best way to detect metastases, and it has implications for adjuvant therapies. The results of this study indicate that routinely sacrificing the intercostobrachial nerves during axillary dissection may result in annoying sensory changes and that efforts should be made to preserve one or two of these nerves during the operation.
PubMed: 7772089
Affiliations:
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Hennipman</name></author><author><name sortKey="De Kruif, J T" sort="De Kruif, J T" uniqKey="De Kruif J" first="J T" last="De Kruif">J T De Kruif</name></author><author><name sortKey="Van Der Tweel, I" sort="Van Der Tweel, I" uniqKey="Van Der Tweel I" first="I" last="Van Der Tweel">I. Van Der Tweel</name></author><author><name sortKey="De Graaf, P W" sort="De Graaf, P W" uniqKey="De Graaf P" first="P W" last="De Graaf">P W De Graaf</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="1993">1993</date><idno type="RBID">pubmed:7772089</idno><idno type="pmid">7772089</idno><idno type="wicri:Area/PubMed/Corpus">005659</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">005659</idno><idno type="wicri:Area/PubMed/Curation">005659</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">005659</idno><idno type="wicri:Area/PubMed/Checkpoint">005659</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">005659</idno><idno type="wicri:Area/Ncbi/Merge">00B223</idno><idno type="wicri:Area/Ncbi/Curation">00B223</idno><idno type="wicri:Area/Ncbi/Checkpoint">00B223</idno><idno type="wicri:doubleKey">0028-2162:1993:Van Dam M:complications:following:axillary</idno><idno type="wicri:Area/Main/Merge">00D581</idno><idno type="wicri:Area/Main/Curation">00CB96</idno><idno type="wicri:Area/Main/Exploration">00CB96</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">[Complications following axillary dissection for breast carcinoma].</title><author><name sortKey="Van Dam, M S" sort="Van Dam, M S" uniqKey="Van Dam M" first="M S" last="Van Dam">M S Van Dam</name><affiliation wicri:level="3"><nlm:affiliation>Academisch Ziekenhuis, afd. Chirurgie, Utrecht.</nlm:affiliation><country>Pays-Bas</country><placeName><settlement type="city">Utrecht</settlement><region nuts="2" type="province">Utrecht (province)</region></placeName><wicri:orgArea>Academisch Ziekenhuis, afd. Chirurgie</wicri:orgArea></affiliation></author><author><name sortKey="Hennipman, A" sort="Hennipman, A" uniqKey="Hennipman A" first="A" last="Hennipman">A. Hennipman</name></author><author><name sortKey="De Kruif, J T" sort="De Kruif, J T" uniqKey="De Kruif J" first="J T" last="De Kruif">J T De Kruif</name></author><author><name sortKey="Van Der Tweel, I" sort="Van Der Tweel, I" uniqKey="Van Der Tweel I" first="I" last="Van Der Tweel">I. Van Der Tweel</name></author><author><name sortKey="De Graaf, P W" sort="De Graaf, P W" uniqKey="De Graaf P" first="P W" last="De Graaf">P W De Graaf</name></author></analytic><series><title level="j">Nederlands tijdschrift voor geneeskunde</title><idno type="ISSN">0028-2162</idno><imprint><date when="1993" type="published">1993</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Humans</term><term>Lymphedema (etiology)</term><term>Mastectomy (methods)</term><term>Mastectomy, Radical</term><term>Mastectomy, Segmental</term><term>Middle Aged</term><term>Necrosis</term><term>Pain, Postoperative</term><term>Postoperative Complications (etiology)</term><term>Surgical Wound Infection (etiology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Complications postopératoires (étiologie)</term><term>Douleur postopératoire</term><term>Femelle</term><term>Humains</term><term>Infection de plaie opératoire (étiologie)</term><term>Lymphoedème (étiologie)</term><term>Mastectomie ()</term><term>Mastectomie partielle</term><term>Mastectomie radicale</term><term>Nécrose</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term><term>Postoperative Complications</term><term>Surgical Wound Infection</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Mastectomy</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Complications postopératoires</term><term>Infection de plaie opératoire</term><term>Lymphoedème</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Humans</term><term>Mastectomy, Radical</term><term>Mastectomy, Segmental</term><term>Middle Aged</term><term>Necrosis</term><term>Pain, Postoperative</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Douleur postopératoire</term><term>Femelle</term><term>Humains</term><term>Mastectomie</term><term>Mastectomie partielle</term><term>Mastectomie radicale</term><term>Nécrose</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Axillary dissection in breast cancer is performed to stage the tumor and to obtain regional tumour control. It is associated with some morbidity. Recently mention was made of post-axillary dissection pain of the arm following damage to one or more of the intercostobrachial nerves. In the University Hospital of Utrecht a radical axillary dissection is routinely performed for breast cancer with transection of the sensory intercostobrachial nerve(s). To evaluate the inherent morbidity of this operation, we interviewed and examined 71 women (75 axillae) who had undergone an axillary dissection for carcinoma of the breast between January 1987 and January 1990. In almost all cases a sensory deficit was present in the axilla and/or arm. In 23 patients (26 sides; 35%) there was pain in the arm, always in the innervation area of the intercostobrachial nerves. One-third of these cases had a NRS score of 5 or higher, indicating moderate to severe pain. Seroma and lymphedema were found in 21 patients. In 6 shoulders abduction was reduced to 90 degrees. The several complaints were non-invalidating to 48 patients, slightly invalidating to 13 and moderately invalidating to 10 patients. At present, histological examination of the axillary nodes is still the best way to detect metastases, and it has implications for adjuvant therapies. The results of this study indicate that routinely sacrificing the intercostobrachial nerves during axillary dissection may result in annoying sensory changes and that efforts should be made to preserve one or two of these nerves during the operation.</div></front></TEI><affiliations><list><country><li>Pays-Bas</li></country><region><li>Utrecht (province)</li></region><settlement><li>Utrecht</li></settlement></list><tree><noCountry><name sortKey="De Graaf, P W" sort="De Graaf, P W" uniqKey="De Graaf P" first="P W" last="De Graaf">P W De Graaf</name><name sortKey="De Kruif, J T" sort="De Kruif, J T" uniqKey="De Kruif J" first="J T" last="De Kruif">J T De Kruif</name><name sortKey="Hennipman, A" sort="Hennipman, A" uniqKey="Hennipman A" first="A" last="Hennipman">A. Hennipman</name><name sortKey="Van Der Tweel, I" sort="Van Der Tweel, I" uniqKey="Van Der Tweel I" first="I" last="Van Der Tweel">I. Van Der Tweel</name></noCountry><country name="Pays-Bas"><region name="Utrecht (province)"><name sortKey="Van Dam, M S" sort="Van Dam, M S" uniqKey="Van Dam M" first="M S" last="Van Dam">M S Van Dam</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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