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Comparison of Lymphedema in Patients With Axillary Lymph Node Dissections to Those With Sentinel Lymph Node Biopsy Followed by Immediate and Delayed ALND

Identifieur interne : 000038 ( PascalFrancis/Corpus ); précédent : 000037; suivant : 000039

Comparison of Lymphedema in Patients With Axillary Lymph Node Dissections to Those With Sentinel Lymph Node Biopsy Followed by Immediate and Delayed ALND

Auteurs : Nafisa Kayam Kuwajerwala ; Claire Feczko ; Nayana Dekhne ; Jane Pettinga ; Victoria C. Lucia ; Justin Riutta ; Frank Vicini

Source :

RBID : Pascal:13-0097750

Descripteurs français

English descriptors

Abstract

Purpose: The purpose of the study was to show that delayed axillary lymph node dissection (ALND) has higher rates of lymphedema compared with immediate ALND, using data from NSABP-B32 at Beaumont Hospital. Method: NSABP B-32 at Beaumont had 207 patients with follow-up data on 199 patients, randomizing clinically negative axilla to sentinel lymph node biopsy (SLNB)+ALND (GrA N=98), and SLNB+cytology±ALND (GrB N = 101). All patients had preoperative volumetric arm measurements and only node negatives had routine postoperative measurements assessing lymphedema for 36 months. We contacted node-positive patients for postoperative measurements for this study. Twenty-four and 15 cytology-positive patients had SLNB+ALND in GrA and GrB, respectively (SubGrA1 N=24; SubGrB1 N=15). Fourteen hematoxylin and eosin-positive patients had delayed ALND (SubGrB2a N = 14). Results: Lymphedema rate for node-positive SLNB+ALND was 10.3% [SubGrA1 (3/24)+SubGrB1 (1/15)=4/39] and node-negative SLNB+ ALND was 6.8% (SubGrA2=5/74). Lymphedema was 14.3% for delayed ALND in SubGrB2a (2 of 14) and 0% for 72 SLNBs in SubGrB2b. Our study comparing immediate and delayed ALND lymphedema was not statistically significant (10.3% vs. 14.3%, P= 0.65). Comparing node-negative ALND (SubGrA2= 5/74=6.8%) to node-positive ALND (A1+B1+B2a = 6/53 = 11.3%) was not statistically significant (P = 0.52). Comparing lymphedema for node-negative ALND (SubGrA2) to SLNB (SubGrB2b) only approached significance (6.8% vs. 0%, P=0.058). Conclusions: The rate of lymphedema was higher in delayed ALND but not statistically significant. Comparison, however, is difficult, given the limited sample size. We urge the other centers of NSABP-B32 to validate this, by contacting the node-positive patients for measurements. The lymphedema rate for SLNB alone was 0% and approached statistical significance when compared with node-negative ALND.

Notice en format standard (ISO 2709)

Pour connaître la documentation sur le format Inist Standard.

pA  
A01 01  1    @0 0277-3732
A02 01      @0 AJCODI
A03   1    @0 Am. j. clin. oncol.
A05       @2 36
A06       @2 1
A08 01  1  ENG  @1 Comparison of Lymphedema in Patients With Axillary Lymph Node Dissections to Those With Sentinel Lymph Node Biopsy Followed by Immediate and Delayed ALND
A11 01  1    @1 KAYAM KUWAJERWALA (Nafisa)
A11 02  1    @1 FECZKO (Claire)
A11 03  1    @1 DEKHNE (Nayana)
A11 04  1    @1 PETTINGA (Jane)
A11 05  1    @1 LUCIA (Victoria C.)
A11 06  1    @1 RIUTTA (Justin)
A11 07  1    @1 VICINI (Frank)
A14 01      @1 Department of Surgery, William Beaumont Hospital @2 Troy and Royal Oak @3 USA @Z 1 aut. @Z 3 aut. @Z 4 aut.
A14 02      @1 Department of Cancer Clinical Trials @2 Troy and Royal Oak @3 USA @Z 2 aut.
A14 03      @1 Department of Physical Medicine and Rehabilitation, William Beaumont Hospital @2 Troy and Royal Oak @3 USA @Z 6 aut.
A14 04      @1 Research Institute, William Beaumont Hospital @3 USA @Z 5 aut.
A20       @1 20-23
A21       @1 2013
A23 01      @0 ENG
A43 01      @1 INIST @2 18032 @5 354000182534510040
A44       @0 0000 @1 © 2013 INIST-CNRS. All rights reserved.
A45       @0 11 ref.
A47 01  1    @0 13-0097750
A60       @1 P
A61       @0 A
A64 01  1    @0 American journal of clinical oncology
A66 01      @0 USA
C01 01    ENG  @0 Purpose: The purpose of the study was to show that delayed axillary lymph node dissection (ALND) has higher rates of lymphedema compared with immediate ALND, using data from NSABP-B32 at Beaumont Hospital. Method: NSABP B-32 at Beaumont had 207 patients with follow-up data on 199 patients, randomizing clinically negative axilla to sentinel lymph node biopsy (SLNB)+ALND (GrA N=98), and SLNB+cytology±ALND (GrB N = 101). All patients had preoperative volumetric arm measurements and only node negatives had routine postoperative measurements assessing lymphedema for 36 months. We contacted node-positive patients for postoperative measurements for this study. Twenty-four and 15 cytology-positive patients had SLNB+ALND in GrA and GrB, respectively (SubGrA1 N=24; SubGrB1 N=15). Fourteen hematoxylin and eosin-positive patients had delayed ALND (SubGrB2a N = 14). Results: Lymphedema rate for node-positive SLNB+ALND was 10.3% [SubGrA1 (3/24)+SubGrB1 (1/15)=4/39] and node-negative SLNB+ ALND was 6.8% (SubGrA2=5/74). Lymphedema was 14.3% for delayed ALND in SubGrB2a (2 of 14) and 0% for 72 SLNBs in SubGrB2b. Our study comparing immediate and delayed ALND lymphedema was not statistically significant (10.3% vs. 14.3%, P= 0.65). Comparing node-negative ALND (SubGrA2= 5/74=6.8%) to node-positive ALND (A1+B1+B2a = 6/53 = 11.3%) was not statistically significant (P = 0.52). Comparing lymphedema for node-negative ALND (SubGrA2) to SLNB (SubGrB2b) only approached significance (6.8% vs. 0%, P=0.058). Conclusions: The rate of lymphedema was higher in delayed ALND but not statistically significant. Comparison, however, is difficult, given the limited sample size. We urge the other centers of NSABP-B32 to validate this, by contacting the node-positive patients for measurements. The lymphedema rate for SLNB alone was 0% and approached statistical significance when compared with node-negative ALND.
C02 01  X    @0 002B25
C03 01  X  FRE  @0 Etude comparative @5 01
C03 01  X  ENG  @0 Comparative study @5 01
C03 01  X  SPA  @0 Estudio comparativo @5 01
C03 02  X  FRE  @0 Lymphoedème @5 02
C03 02  X  ENG  @0 Lymphedema @5 02
C03 02  X  SPA  @0 Linfedema @5 02
C03 03  X  FRE  @0 Homme @5 03
C03 03  X  ENG  @0 Human @5 03
C03 03  X  SPA  @0 Hombre @5 03
C03 04  X  FRE  @0 Complication @5 04
C03 04  X  ENG  @0 Complication @5 04
C03 04  X  SPA  @0 Complicación @5 04
C03 05  X  FRE  @0 Ganglion axillaire @5 05
C03 05  X  ENG  @0 Axillary ganglion @5 05
C03 05  X  SPA  @0 Ganglio axilar @5 05
C03 06  X  FRE  @0 Lymphadénectomie @5 06
C03 06  X  ENG  @0 Lymphadenectomy @5 06
C03 06  X  SPA  @0 Linfadenectomía @5 06
C03 07  X  FRE  @0 Ganglion sentinelle @5 07
C03 07  X  ENG  @0 Sentinel lymph node @5 07
C03 07  X  SPA  @0 Ganglio centinela @5 07
C03 08  X  FRE  @0 Biopsie @5 08
C03 08  X  ENG  @0 Biopsy @5 08
C03 08  X  SPA  @0 Biopsia @5 08
C03 09  X  FRE  @0 Anatomopathologie @5 09
C03 09  X  ENG  @0 Anatomic pathology @5 09
C03 09  X  SPA  @0 Anatomía patológica @5 09
C03 10  X  FRE  @0 Traitement @5 23
C03 10  X  ENG  @0 Treatment @5 23
C03 10  X  SPA  @0 Tratamiento @5 23
C07 01  X  FRE  @0 Pathologie de l'appareil circulatoire @5 37
C07 01  X  ENG  @0 Cardiovascular disease @5 37
C07 01  X  SPA  @0 Aparato circulatorio patología @5 37
C07 02  X  FRE  @0 Pathologie des vaisseaux lymphatiques @5 38
C07 02  X  ENG  @0 Lymphatic vessel disease @5 38
C07 02  X  SPA  @0 Linfático patología @5 38
C07 03  X  FRE  @0 Chirurgie @5 39
C07 03  X  ENG  @0 Surgery @5 39
C07 03  X  SPA  @0 Cirugía @5 39
N21       @1 070

Format Inist (serveur)

NO : PASCAL 13-0097750 INIST
ET : Comparison of Lymphedema in Patients With Axillary Lymph Node Dissections to Those With Sentinel Lymph Node Biopsy Followed by Immediate and Delayed ALND
AU : KAYAM KUWAJERWALA (Nafisa); FECZKO (Claire); DEKHNE (Nayana); PETTINGA (Jane); LUCIA (Victoria C.); RIUTTA (Justin); VICINI (Frank)
AF : Department of Surgery, William Beaumont Hospital/Troy and Royal Oak/Etats-Unis (1 aut., 3 aut., 4 aut.); Department of Cancer Clinical Trials/Troy and Royal Oak/Etats-Unis (2 aut.); Department of Physical Medicine and Rehabilitation, William Beaumont Hospital/Troy and Royal Oak/Etats-Unis (6 aut.); Research Institute, William Beaumont Hospital/Etats-Unis (5 aut.)
DT : Publication en série; Niveau analytique
SO : American journal of clinical oncology; ISSN 0277-3732; Coden AJCODI; Etats-Unis; Da. 2013; Vol. 36; No. 1; Pp. 20-23; Bibl. 11 ref.
LA : Anglais
EA : Purpose: The purpose of the study was to show that delayed axillary lymph node dissection (ALND) has higher rates of lymphedema compared with immediate ALND, using data from NSABP-B32 at Beaumont Hospital. Method: NSABP B-32 at Beaumont had 207 patients with follow-up data on 199 patients, randomizing clinically negative axilla to sentinel lymph node biopsy (SLNB)+ALND (GrA N=98), and SLNB+cytology±ALND (GrB N = 101). All patients had preoperative volumetric arm measurements and only node negatives had routine postoperative measurements assessing lymphedema for 36 months. We contacted node-positive patients for postoperative measurements for this study. Twenty-four and 15 cytology-positive patients had SLNB+ALND in GrA and GrB, respectively (SubGrA1 N=24; SubGrB1 N=15). Fourteen hematoxylin and eosin-positive patients had delayed ALND (SubGrB2a N = 14). Results: Lymphedema rate for node-positive SLNB+ALND was 10.3% [SubGrA1 (3/24)+SubGrB1 (1/15)=4/39] and node-negative SLNB+ ALND was 6.8% (SubGrA2=5/74). Lymphedema was 14.3% for delayed ALND in SubGrB2a (2 of 14) and 0% for 72 SLNBs in SubGrB2b. Our study comparing immediate and delayed ALND lymphedema was not statistically significant (10.3% vs. 14.3%, P= 0.65). Comparing node-negative ALND (SubGrA2= 5/74=6.8%) to node-positive ALND (A1+B1+B2a = 6/53 = 11.3%) was not statistically significant (P = 0.52). Comparing lymphedema for node-negative ALND (SubGrA2) to SLNB (SubGrB2b) only approached significance (6.8% vs. 0%, P=0.058). Conclusions: The rate of lymphedema was higher in delayed ALND but not statistically significant. Comparison, however, is difficult, given the limited sample size. We urge the other centers of NSABP-B32 to validate this, by contacting the node-positive patients for measurements. The lymphedema rate for SLNB alone was 0% and approached statistical significance when compared with node-negative ALND.
CC : 002B25
FD : Etude comparative; Lymphoedème; Homme; Complication; Ganglion axillaire; Lymphadénectomie; Ganglion sentinelle; Biopsie; Anatomopathologie; Traitement
FG : Pathologie de l'appareil circulatoire; Pathologie des vaisseaux lymphatiques; Chirurgie
ED : Comparative study; Lymphedema; Human; Complication; Axillary ganglion; Lymphadenectomy; Sentinel lymph node; Biopsy; Anatomic pathology; Treatment
EG : Cardiovascular disease; Lymphatic vessel disease; Surgery
SD : Estudio comparativo; Linfedema; Hombre; Complicación; Ganglio axilar; Linfadenectomía; Ganglio centinela; Biopsia; Anatomía patológica; Tratamiento
LO : INIST-18032.354000182534510040
ID : 13-0097750

Links to Exploration step

Pascal:13-0097750

Le document en format XML

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<div type="abstract" xml:lang="en">Purpose: The purpose of the study was to show that delayed axillary lymph node dissection (ALND) has higher rates of lymphedema compared with immediate ALND, using data from NSABP-B32 at Beaumont Hospital. Method: NSABP B-32 at Beaumont had 207 patients with follow-up data on 199 patients, randomizing clinically negative axilla to sentinel lymph node biopsy (SLNB)+ALND (GrA N=98), and SLNB+cytology±ALND (GrB N = 101). All patients had preoperative volumetric arm measurements and only node negatives had routine postoperative measurements assessing lymphedema for 36 months. We contacted node-positive patients for postoperative measurements for this study. Twenty-four and 15 cytology-positive patients had SLNB+ALND in GrA and GrB, respectively (SubGrA1 N=24; SubGrB1 N=15). Fourteen hematoxylin and eosin-positive patients had delayed ALND (SubGrB2a N = 14). Results: Lymphedema rate for node-positive SLNB+ALND was 10.3% [SubGrA1 (3/24)+SubGrB1 (1/15)=4/39] and node-negative SLNB+ ALND was 6.8% (SubGrA2=5/74). Lymphedema was 14.3% for delayed ALND in SubGrB2a (2 of 14) and 0% for 72 SLNBs in SubGrB2b. Our study comparing immediate and delayed ALND lymphedema was not statistically significant (10.3% vs. 14.3%, P= 0.65). Comparing node-negative ALND (SubGrA2= 5/74=6.8%) to node-positive ALND (A1+B1+B2a = 6/53 = 11.3%) was not statistically significant (P = 0.52). Comparing lymphedema for node-negative ALND (SubGrA2) to SLNB (SubGrB2b) only approached significance (6.8% vs. 0%, P=0.058). Conclusions: The rate of lymphedema was higher in delayed ALND but not statistically significant. Comparison, however, is difficult, given the limited sample size. We urge the other centers of NSABP-B32 to validate this, by contacting the node-positive patients for measurements. The lymphedema rate for SLNB alone was 0% and approached statistical significance when compared with node-negative ALND.</div>
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<sZ>3 aut.</sZ>
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</fA14>
<fA14 i1="02">
<s1>Department of Cancer Clinical Trials</s1>
<s2>Troy and Royal Oak</s2>
<s3>USA</s3>
<sZ>2 aut.</sZ>
</fA14>
<fA14 i1="03">
<s1>Department of Physical Medicine and Rehabilitation, William Beaumont Hospital</s1>
<s2>Troy and Royal Oak</s2>
<s3>USA</s3>
<sZ>6 aut.</sZ>
</fA14>
<fA14 i1="04">
<s1>Research Institute, William Beaumont Hospital</s1>
<s3>USA</s3>
<sZ>5 aut.</sZ>
</fA14>
<fA20>
<s1>20-23</s1>
</fA20>
<fA21>
<s1>2013</s1>
</fA21>
<fA23 i1="01">
<s0>ENG</s0>
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<s0>11 ref.</s0>
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<s0>13-0097750</s0>
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<s1>P</s1>
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<s0>A</s0>
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<fA64 i1="01" i2="1">
<s0>American journal of clinical oncology</s0>
</fA64>
<fA66 i1="01">
<s0>USA</s0>
</fA66>
<fC01 i1="01" l="ENG">
<s0>Purpose: The purpose of the study was to show that delayed axillary lymph node dissection (ALND) has higher rates of lymphedema compared with immediate ALND, using data from NSABP-B32 at Beaumont Hospital. Method: NSABP B-32 at Beaumont had 207 patients with follow-up data on 199 patients, randomizing clinically negative axilla to sentinel lymph node biopsy (SLNB)+ALND (GrA N=98), and SLNB+cytology±ALND (GrB N = 101). All patients had preoperative volumetric arm measurements and only node negatives had routine postoperative measurements assessing lymphedema for 36 months. We contacted node-positive patients for postoperative measurements for this study. Twenty-four and 15 cytology-positive patients had SLNB+ALND in GrA and GrB, respectively (SubGrA1 N=24; SubGrB1 N=15). Fourteen hematoxylin and eosin-positive patients had delayed ALND (SubGrB2a N = 14). Results: Lymphedema rate for node-positive SLNB+ALND was 10.3% [SubGrA1 (3/24)+SubGrB1 (1/15)=4/39] and node-negative SLNB+ ALND was 6.8% (SubGrA2=5/74). Lymphedema was 14.3% for delayed ALND in SubGrB2a (2 of 14) and 0% for 72 SLNBs in SubGrB2b. Our study comparing immediate and delayed ALND lymphedema was not statistically significant (10.3% vs. 14.3%, P= 0.65). Comparing node-negative ALND (SubGrA2= 5/74=6.8%) to node-positive ALND (A1+B1+B2a = 6/53 = 11.3%) was not statistically significant (P = 0.52). Comparing lymphedema for node-negative ALND (SubGrA2) to SLNB (SubGrB2b) only approached significance (6.8% vs. 0%, P=0.058). Conclusions: The rate of lymphedema was higher in delayed ALND but not statistically significant. Comparison, however, is difficult, given the limited sample size. We urge the other centers of NSABP-B32 to validate this, by contacting the node-positive patients for measurements. The lymphedema rate for SLNB alone was 0% and approached statistical significance when compared with node-negative ALND.</s0>
</fC01>
<fC02 i1="01" i2="X">
<s0>002B25</s0>
</fC02>
<fC03 i1="01" i2="X" l="FRE">
<s0>Etude comparative</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="ENG">
<s0>Comparative study</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="SPA">
<s0>Estudio comparativo</s0>
<s5>01</s5>
</fC03>
<fC03 i1="02" i2="X" l="FRE">
<s0>Lymphoedème</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="ENG">
<s0>Lymphedema</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="SPA">
<s0>Linfedema</s0>
<s5>02</s5>
</fC03>
<fC03 i1="03" i2="X" l="FRE">
<s0>Homme</s0>
<s5>03</s5>
</fC03>
<fC03 i1="03" i2="X" l="ENG">
<s0>Human</s0>
<s5>03</s5>
</fC03>
<fC03 i1="03" i2="X" l="SPA">
<s0>Hombre</s0>
<s5>03</s5>
</fC03>
<fC03 i1="04" i2="X" l="FRE">
<s0>Complication</s0>
<s5>04</s5>
</fC03>
<fC03 i1="04" i2="X" l="ENG">
<s0>Complication</s0>
<s5>04</s5>
</fC03>
<fC03 i1="04" i2="X" l="SPA">
<s0>Complicación</s0>
<s5>04</s5>
</fC03>
<fC03 i1="05" i2="X" l="FRE">
<s0>Ganglion axillaire</s0>
<s5>05</s5>
</fC03>
<fC03 i1="05" i2="X" l="ENG">
<s0>Axillary ganglion</s0>
<s5>05</s5>
</fC03>
<fC03 i1="05" i2="X" l="SPA">
<s0>Ganglio axilar</s0>
<s5>05</s5>
</fC03>
<fC03 i1="06" i2="X" l="FRE">
<s0>Lymphadénectomie</s0>
<s5>06</s5>
</fC03>
<fC03 i1="06" i2="X" l="ENG">
<s0>Lymphadenectomy</s0>
<s5>06</s5>
</fC03>
<fC03 i1="06" i2="X" l="SPA">
<s0>Linfadenectomía</s0>
<s5>06</s5>
</fC03>
<fC03 i1="07" i2="X" l="FRE">
<s0>Ganglion sentinelle</s0>
<s5>07</s5>
</fC03>
<fC03 i1="07" i2="X" l="ENG">
<s0>Sentinel lymph node</s0>
<s5>07</s5>
</fC03>
<fC03 i1="07" i2="X" l="SPA">
<s0>Ganglio centinela</s0>
<s5>07</s5>
</fC03>
<fC03 i1="08" i2="X" l="FRE">
<s0>Biopsie</s0>
<s5>08</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG">
<s0>Biopsy</s0>
<s5>08</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA">
<s0>Biopsia</s0>
<s5>08</s5>
</fC03>
<fC03 i1="09" i2="X" l="FRE">
<s0>Anatomopathologie</s0>
<s5>09</s5>
</fC03>
<fC03 i1="09" i2="X" l="ENG">
<s0>Anatomic pathology</s0>
<s5>09</s5>
</fC03>
<fC03 i1="09" i2="X" l="SPA">
<s0>Anatomía patológica</s0>
<s5>09</s5>
</fC03>
<fC03 i1="10" i2="X" l="FRE">
<s0>Traitement</s0>
<s5>23</s5>
</fC03>
<fC03 i1="10" i2="X" l="ENG">
<s0>Treatment</s0>
<s5>23</s5>
</fC03>
<fC03 i1="10" i2="X" l="SPA">
<s0>Tratamiento</s0>
<s5>23</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE">
<s0>Pathologie de l'appareil circulatoire</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="ENG">
<s0>Cardiovascular disease</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="SPA">
<s0>Aparato circulatorio patología</s0>
<s5>37</s5>
</fC07>
<fC07 i1="02" i2="X" l="FRE">
<s0>Pathologie des vaisseaux lymphatiques</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="ENG">
<s0>Lymphatic vessel disease</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="SPA">
<s0>Linfático patología</s0>
<s5>38</s5>
</fC07>
<fC07 i1="03" i2="X" l="FRE">
<s0>Chirurgie</s0>
<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="ENG">
<s0>Surgery</s0>
<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="SPA">
<s0>Cirugía</s0>
<s5>39</s5>
</fC07>
<fN21>
<s1>070</s1>
</fN21>
</pA>
</standard>
<server>
<NO>PASCAL 13-0097750 INIST</NO>
<ET>Comparison of Lymphedema in Patients With Axillary Lymph Node Dissections to Those With Sentinel Lymph Node Biopsy Followed by Immediate and Delayed ALND</ET>
<AU>KAYAM KUWAJERWALA (Nafisa); FECZKO (Claire); DEKHNE (Nayana); PETTINGA (Jane); LUCIA (Victoria C.); RIUTTA (Justin); VICINI (Frank)</AU>
<AF>Department of Surgery, William Beaumont Hospital/Troy and Royal Oak/Etats-Unis (1 aut., 3 aut., 4 aut.); Department of Cancer Clinical Trials/Troy and Royal Oak/Etats-Unis (2 aut.); Department of Physical Medicine and Rehabilitation, William Beaumont Hospital/Troy and Royal Oak/Etats-Unis (6 aut.); Research Institute, William Beaumont Hospital/Etats-Unis (5 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>American journal of clinical oncology; ISSN 0277-3732; Coden AJCODI; Etats-Unis; Da. 2013; Vol. 36; No. 1; Pp. 20-23; Bibl. 11 ref.</SO>
<LA>Anglais</LA>
<EA>Purpose: The purpose of the study was to show that delayed axillary lymph node dissection (ALND) has higher rates of lymphedema compared with immediate ALND, using data from NSABP-B32 at Beaumont Hospital. Method: NSABP B-32 at Beaumont had 207 patients with follow-up data on 199 patients, randomizing clinically negative axilla to sentinel lymph node biopsy (SLNB)+ALND (GrA N=98), and SLNB+cytology±ALND (GrB N = 101). All patients had preoperative volumetric arm measurements and only node negatives had routine postoperative measurements assessing lymphedema for 36 months. We contacted node-positive patients for postoperative measurements for this study. Twenty-four and 15 cytology-positive patients had SLNB+ALND in GrA and GrB, respectively (SubGrA1 N=24; SubGrB1 N=15). Fourteen hematoxylin and eosin-positive patients had delayed ALND (SubGrB2a N = 14). Results: Lymphedema rate for node-positive SLNB+ALND was 10.3% [SubGrA1 (3/24)+SubGrB1 (1/15)=4/39] and node-negative SLNB+ ALND was 6.8% (SubGrA2=5/74). Lymphedema was 14.3% for delayed ALND in SubGrB2a (2 of 14) and 0% for 72 SLNBs in SubGrB2b. Our study comparing immediate and delayed ALND lymphedema was not statistically significant (10.3% vs. 14.3%, P= 0.65). Comparing node-negative ALND (SubGrA2= 5/74=6.8%) to node-positive ALND (A1+B1+B2a = 6/53 = 11.3%) was not statistically significant (P = 0.52). Comparing lymphedema for node-negative ALND (SubGrA2) to SLNB (SubGrB2b) only approached significance (6.8% vs. 0%, P=0.058). Conclusions: The rate of lymphedema was higher in delayed ALND but not statistically significant. Comparison, however, is difficult, given the limited sample size. We urge the other centers of NSABP-B32 to validate this, by contacting the node-positive patients for measurements. The lymphedema rate for SLNB alone was 0% and approached statistical significance when compared with node-negative ALND.</EA>
<CC>002B25</CC>
<FD>Etude comparative; Lymphoedème; Homme; Complication; Ganglion axillaire; Lymphadénectomie; Ganglion sentinelle; Biopsie; Anatomopathologie; Traitement</FD>
<FG>Pathologie de l'appareil circulatoire; Pathologie des vaisseaux lymphatiques; Chirurgie</FG>
<ED>Comparative study; Lymphedema; Human; Complication; Axillary ganglion; Lymphadenectomy; Sentinel lymph node; Biopsy; Anatomic pathology; Treatment</ED>
<EG>Cardiovascular disease; Lymphatic vessel disease; Surgery</EG>
<SD>Estudio comparativo; Linfedema; Hombre; Complicación; Ganglio axilar; Linfadenectomía; Ganglio centinela; Biopsia; Anatomía patológica; Tratamiento</SD>
<LO>INIST-18032.354000182534510040</LO>
<ID>13-0097750</ID>
</server>
</inist>
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