Sentinel lymph node biopsy at the time of mastectomy does not increase the risk of lymphedema: implications for prophylactic surgery.
Identifieur interne : 001F78 ( PubMed/Corpus ); précédent : 001F77; suivant : 001F79Sentinel lymph node biopsy at the time of mastectomy does not increase the risk of lymphedema: implications for prophylactic surgery.
Auteurs : Cynthia L. Miller ; Michelle C. Specht ; Melissa N. Skolny ; Lauren S. Jammallo ; Nora Horick ; Jean O'Toole ; Suzanne B. Coopey ; Kevin Hughes ; Michele Gadd ; Barbara L. Smith ; Alphonse G. TaghianSource :
- Breast cancer research and treatment [ 1573-7217 ] ; 2012.
English descriptors
- KwdEn :
- Adult, Aged, Arm (pathology), Axilla (surgery), Body Mass Index, Breast Neoplasms (surgery), Female, Humans, Lymph Node Excision (adverse effects), Lymphedema (etiology), Lymphedema (therapy), Mastectomy, Middle Aged, Multivariate Analysis, Postoperative Period, Preventive Medicine (methods), Prospective Studies, Risk Factors, Sentinel Lymph Node Biopsy (adverse effects), Young Adult.
- MESH :
- adverse effects : Lymph Node Excision, Sentinel Lymph Node Biopsy.
- etiology : Lymphedema.
- methods : Preventive Medicine.
- pathology : Arm.
- surgery : Axilla, Breast Neoplasms.
- therapy : Lymphedema.
- Adult, Aged, Body Mass Index, Female, Humans, Mastectomy, Middle Aged, Multivariate Analysis, Postoperative Period, Prospective Studies, Risk Factors, Young Adult.
Abstract
Women diagnosed with or at high risk for breast cancer increasingly choose prophylactic mastectomy. It is unknown if adding sentinel lymph node biopsy (SLNB) to prophylactic mastectomy increases the risk of lymphedema. We sought to determine the risk of lymphedema after mastectomy with and without nodal evaluation. 117 patients who underwent bilateral mastectomy were prospectively screened for lymphedema. Perometer arm measurements were used to calculate weight-adjusted arm volume change at each follow-up. Of 234 mastectomies performed, 15.8 % (37/234) had no axillary surgery, 63.7 % (149/234) had SLNB, and 20.5 % (48/234) had axillary lymph node dissection (ALND). 88.0 % (103/117) of patients completed the LEFT-BC questionnaire evaluating symptoms associated with lymphedema. Multivariate analysis was used to assess clinical characteristics associated with increased weight-adjusted arm volume and patient-reported lymphedema symptoms. SLNB at the time of mastectomy did not result in an increased mean weight-adjusted arm volume compared to mastectomy without axillary surgery (p = 0.76). Mastectomy with ALND was associated with a significantly greater mean weight-adjusted arm volume change compared to mastectomy with SLNB (p < 0.0001) and without axillary surgery (p = 0.0028). Patients who underwent mastectomy with ALND more commonly reported symptoms associated with lymphedema compared to those with SLNB or no axillary surgery (p < 0.0001). Patients who underwent mastectomy with SLNB or no axillary surgery reported similar lymphedema symptoms. Addition of SLNB to mastectomy is not associated with a significant increase in measured or self-reported lymphedema rates. Therefore, SLNB may be performed at the time of prophylactic mastectomy without an increased risk of lymphedema.
DOI: 10.1007/s10549-012-2231-1
PubMed: 22941538
Links to Exploration step
pubmed:22941538Le document en format XML
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Jammallo</name></author><author><name sortKey="Horick, Nora" sort="Horick, Nora" uniqKey="Horick N" first="Nora" last="Horick">Nora Horick</name></author><author><name sortKey="O Toole, Jean" sort="O Toole, Jean" uniqKey="O Toole J" first="Jean" last="O'Toole">Jean O'Toole</name></author><author><name sortKey="Coopey, Suzanne B" sort="Coopey, Suzanne B" uniqKey="Coopey S" first="Suzanne B" last="Coopey">Suzanne B. Coopey</name></author><author><name sortKey="Hughes, Kevin" sort="Hughes, Kevin" uniqKey="Hughes K" first="Kevin" last="Hughes">Kevin Hughes</name></author><author><name sortKey="Gadd, Michele" sort="Gadd, Michele" uniqKey="Gadd M" first="Michele" last="Gadd">Michele Gadd</name></author><author><name sortKey="Smith, Barbara L" sort="Smith, Barbara L" uniqKey="Smith B" first="Barbara L" last="Smith">Barbara L. Smith</name></author><author><name sortKey="Taghian, Alphonse G" sort="Taghian, Alphonse G" uniqKey="Taghian A" first="Alphonse G" last="Taghian">Alphonse G. Taghian</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2012">2012</date><idno type="RBID">pubmed:22941538</idno><idno type="pmid">22941538</idno><idno type="doi">10.1007/s10549-012-2231-1</idno><idno type="wicri:Area/PubMed/Corpus">001F78</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001F78</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Sentinel lymph node biopsy at the time of mastectomy does not increase the risk of lymphedema: implications for prophylactic surgery.</title><author><name sortKey="Miller, Cynthia L" sort="Miller, Cynthia L" uniqKey="Miller C" first="Cynthia L" last="Miller">Cynthia L. Miller</name><affiliation><nlm:affiliation>Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA 02114, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Specht, Michelle C" sort="Specht, Michelle C" uniqKey="Specht M" first="Michelle C" last="Specht">Michelle C. Specht</name></author><author><name sortKey="Skolny, Melissa N" sort="Skolny, Melissa N" uniqKey="Skolny M" first="Melissa N" last="Skolny">Melissa N. Skolny</name></author><author><name sortKey="Jammallo, Lauren S" sort="Jammallo, Lauren S" uniqKey="Jammallo L" first="Lauren S" last="Jammallo">Lauren S. Jammallo</name></author><author><name sortKey="Horick, Nora" sort="Horick, Nora" uniqKey="Horick N" first="Nora" last="Horick">Nora Horick</name></author><author><name sortKey="O Toole, Jean" sort="O Toole, Jean" uniqKey="O Toole J" first="Jean" last="O'Toole">Jean O'Toole</name></author><author><name sortKey="Coopey, Suzanne B" sort="Coopey, Suzanne B" uniqKey="Coopey S" first="Suzanne B" last="Coopey">Suzanne B. Coopey</name></author><author><name sortKey="Hughes, Kevin" sort="Hughes, Kevin" uniqKey="Hughes K" first="Kevin" last="Hughes">Kevin Hughes</name></author><author><name sortKey="Gadd, Michele" sort="Gadd, Michele" uniqKey="Gadd M" first="Michele" last="Gadd">Michele Gadd</name></author><author><name sortKey="Smith, Barbara L" sort="Smith, Barbara L" uniqKey="Smith B" first="Barbara L" last="Smith">Barbara L. Smith</name></author><author><name sortKey="Taghian, Alphonse G" sort="Taghian, Alphonse G" uniqKey="Taghian A" first="Alphonse G" last="Taghian">Alphonse G. Taghian</name></author></analytic><series><title level="j">Breast cancer research and treatment</title><idno type="eISSN">1573-7217</idno><imprint><date when="2012" type="published">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Arm (pathology)</term><term>Axilla (surgery)</term><term>Body Mass Index</term><term>Breast Neoplasms (surgery)</term><term>Female</term><term>Humans</term><term>Lymph Node Excision (adverse effects)</term><term>Lymphedema (etiology)</term><term>Lymphedema (therapy)</term><term>Mastectomy</term><term>Middle Aged</term><term>Multivariate Analysis</term><term>Postoperative Period</term><term>Preventive Medicine (methods)</term><term>Prospective Studies</term><term>Risk Factors</term><term>Sentinel Lymph Node Biopsy (adverse effects)</term><term>Young Adult</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Lymph Node Excision</term><term>Sentinel Lymph Node Biopsy</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Preventive Medicine</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Arm</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Axilla</term><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Body Mass Index</term><term>Female</term><term>Humans</term><term>Mastectomy</term><term>Middle Aged</term><term>Multivariate Analysis</term><term>Postoperative Period</term><term>Prospective Studies</term><term>Risk Factors</term><term>Young Adult</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Women diagnosed with or at high risk for breast cancer increasingly choose prophylactic mastectomy. It is unknown if adding sentinel lymph node biopsy (SLNB) to prophylactic mastectomy increases the risk of lymphedema. We sought to determine the risk of lymphedema after mastectomy with and without nodal evaluation. 117 patients who underwent bilateral mastectomy were prospectively screened for lymphedema. Perometer arm measurements were used to calculate weight-adjusted arm volume change at each follow-up. Of 234 mastectomies performed, 15.8 % (37/234) had no axillary surgery, 63.7 % (149/234) had SLNB, and 20.5 % (48/234) had axillary lymph node dissection (ALND). 88.0 % (103/117) of patients completed the LEFT-BC questionnaire evaluating symptoms associated with lymphedema. Multivariate analysis was used to assess clinical characteristics associated with increased weight-adjusted arm volume and patient-reported lymphedema symptoms. SLNB at the time of mastectomy did not result in an increased mean weight-adjusted arm volume compared to mastectomy without axillary surgery (p = 0.76). Mastectomy with ALND was associated with a significantly greater mean weight-adjusted arm volume change compared to mastectomy with SLNB (p < 0.0001) and without axillary surgery (p = 0.0028). Patients who underwent mastectomy with ALND more commonly reported symptoms associated with lymphedema compared to those with SLNB or no axillary surgery (p < 0.0001). Patients who underwent mastectomy with SLNB or no axillary surgery reported similar lymphedema symptoms. Addition of SLNB to mastectomy is not associated with a significant increase in measured or self-reported lymphedema rates. Therefore, SLNB may be performed at the time of prophylactic mastectomy without an increased risk of lymphedema.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">22941538</PMID><DateCreated><Year>2012</Year><Month>09</Month><Day>12</Day></DateCreated><DateCompleted><Year>2013</Year><Month>04</Month><Day>19</Day></DateCompleted><DateRevised><Year>2017</Year><Month>02</Month><Day>20</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1573-7217</ISSN><JournalIssue CitedMedium="Internet"><Volume>135</Volume><Issue>3</Issue><PubDate><Year>2012</Year><Month>Oct</Month></PubDate></JournalIssue><Title>Breast cancer research and treatment</Title><ISOAbbreviation>Breast Cancer Res. Treat.</ISOAbbreviation></Journal><ArticleTitle>Sentinel lymph node biopsy at the time of mastectomy does not increase the risk of lymphedema: implications for prophylactic surgery.</ArticleTitle><Pagination><MedlinePgn>781-9</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1007/s10549-012-2231-1</ELocationID><Abstract><AbstractText>Women diagnosed with or at high risk for breast cancer increasingly choose prophylactic mastectomy. It is unknown if adding sentinel lymph node biopsy (SLNB) to prophylactic mastectomy increases the risk of lymphedema. We sought to determine the risk of lymphedema after mastectomy with and without nodal evaluation. 117 patients who underwent bilateral mastectomy were prospectively screened for lymphedema. Perometer arm measurements were used to calculate weight-adjusted arm volume change at each follow-up. Of 234 mastectomies performed, 15.8 % (37/234) had no axillary surgery, 63.7 % (149/234) had SLNB, and 20.5 % (48/234) had axillary lymph node dissection (ALND). 88.0 % (103/117) of patients completed the LEFT-BC questionnaire evaluating symptoms associated with lymphedema. Multivariate analysis was used to assess clinical characteristics associated with increased weight-adjusted arm volume and patient-reported lymphedema symptoms. SLNB at the time of mastectomy did not result in an increased mean weight-adjusted arm volume compared to mastectomy without axillary surgery (p = 0.76). Mastectomy with ALND was associated with a significantly greater mean weight-adjusted arm volume change compared to mastectomy with SLNB (p < 0.0001) and without axillary surgery (p = 0.0028). Patients who underwent mastectomy with ALND more commonly reported symptoms associated with lymphedema compared to those with SLNB or no axillary surgery (p < 0.0001). Patients who underwent mastectomy with SLNB or no axillary surgery reported similar lymphedema symptoms. Addition of SLNB to mastectomy is not associated with a significant increase in measured or self-reported lymphedema rates. Therefore, SLNB may be performed at the time of prophylactic mastectomy without an increased risk of lymphedema.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Miller</LastName><ForeName>Cynthia L</ForeName><Initials>CL</Initials><AffiliationInfo><Affiliation>Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA 02114, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Specht</LastName><ForeName>Michelle C</ForeName><Initials>MC</Initials></Author><Author ValidYN="Y"><LastName>Skolny</LastName><ForeName>Melissa N</ForeName><Initials>MN</Initials></Author><Author ValidYN="Y"><LastName>Jammallo</LastName><ForeName>Lauren S</ForeName><Initials>LS</Initials></Author><Author ValidYN="Y"><LastName>Horick</LastName><ForeName>Nora</ForeName><Initials>N</Initials></Author><Author ValidYN="Y"><LastName>O'Toole</LastName><ForeName>Jean</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Coopey</LastName><ForeName>Suzanne B</ForeName><Initials>SB</Initials></Author><Author ValidYN="Y"><LastName>Hughes</LastName><ForeName>Kevin</ForeName><Initials>K</Initials></Author><Author ValidYN="Y"><LastName>Gadd</LastName><ForeName>Michele</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Smith</LastName><ForeName>Barbara L</ForeName><Initials>BL</Initials></Author><Author ValidYN="Y"><LastName>Taghian</LastName><ForeName>Alphonse G</ForeName><Initials>AG</Initials></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>P50 CA089393</GrantID><Acronym>CA</Acronym><Agency>NCI NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01 CA139118</GrantID><Acronym>CA</Acronym><Agency>NCI NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>P50CA089393</GrantID><Acronym>CA</Acronym><Agency>NCI NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01CA139118</GrantID><Acronym>CA</Acronym><Agency>NCI NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016430">Clinical Trial</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D052061">Research Support, N.I.H., Extramural</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2012</Year><Month>09</Month><Day>01</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>Breast Cancer Res Treat</MedlineTA><NlmUniqueID>8111104</NlmUniqueID><ISSNLinking>0167-6806</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>J Clin Oncol. 2009 Mar 20;27(9):1362-7</RefSource><PMID Version="1">19224844</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>Lymphology. 2009 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MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008197" MajorTopicYN="N">Lymph Node Excision</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008209" MajorTopicYN="N">Lymphedema</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008408" MajorTopicYN="Y">Mastectomy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015999" MajorTopicYN="N">Multivariate Analysis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011184" MajorTopicYN="N">Postoperative Period</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011315" MajorTopicYN="N">Preventive Medicine</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D021701" MajorTopicYN="N">Sentinel Lymph Node Biopsy</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList><OtherID Source="NLM">NIHMS435617</OtherID><OtherID Source="NLM">PMC3563357</OtherID></MedlineCitation><PubmedData><History><PubMedPubDate 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