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Complications of axillary lymph node dissection for carcinoma of the breast: a report based on a patient survey.

Publication ,  Journal Article
Warmuth, MA; Bowen, G; Prosnitz, LR; Chu, L; Broadwater, G; Peterson, B; Leight, G; Winer, EP
Published in: Cancer
October 1, 1998

BACKGROUND: Axillary lymph node dissection is commonly performed as part of the primary management of breast carcinoma. Its value in patient management, however, has recently been questioned. Few studies exist that document long term complications. METHODS: Four hundred thirty-two patients with Stage I or II breast carcinoma who were free of recurrence 2-5 years after surgery were identified. A cross-sectional survey was conducted to determine the prevalence of long term symptoms and complications as perceived by the patient, and patient and treatment factors that may have predicted complications were determined. Three hundred thirty of the 432 (76%) completed a mailed, self-administered questionnaire. In addition, the medical records of the 330 patients were reviewed. Patient and treatment factors were analyzed with logistic regression. RESULTS: Numbness was reported by 35% of patients at the time of the survey. Pain was noted in 30%, arm swelling in 15%, and limitation of arm movement in 8%. Eight percent reported episodes of infection or inflammation at some point since the diagnosis of breast carcinoma. The majority of symptoms were mild and interfered minimally with daily activities. Younger age (P=0.001) was associated with more frequent reporting of pain. Numbness was more common in younger patients (P=0.004) as well as in those with a history of smoking (P=0.012). There was a positive association of limitation of arm motion with adjuvant tamoxifen therapy (P=0.016). Arm swelling was associated with both younger age (P=0.004) and greater body surface area (P=0.008). Radiation therapy was associated with a higher frequency of infection or inflammation in the arm and/or breast (P=0.001). CONCLUSIONS: Mild symptoms, especially pain and numbness, are common 2-5 years after axillary lymph node dissection. The frequency of inflammation or infection in patients treated with radiation to the breast or chest wall after an axillary lymph node dissection may be greater than previously appreciated. Severe complications or symptoms that have a major impact on daily activities are uncommon. These findings should help health care providers and their patients with breast carcinoma weigh the pros and cons of axillary lymph node dissection.

Duke Scholars

Published In

Cancer

DOI

ISSN

0008-543X

Publication Date

October 1, 1998

Volume

83

Issue

7

Start / End Page

1362 / 1368

Location

United States

Related Subject Headings

  • Time Factors
  • Surveys and Questionnaires
  • Smoking
  • Radiotherapy
  • Postoperative Complications
  • Pain
  • Oncology & Carcinogenesis
  • Middle Aged
  • Medical Records
  • Lymph Node Excision
 

Citation

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MLA
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Warmuth, M. A., Bowen, G., Prosnitz, L. R., Chu, L., Broadwater, G., Peterson, B., … Winer, E. P. (1998). Complications of axillary lymph node dissection for carcinoma of the breast: a report based on a patient survey. Cancer, 83(7), 1362–1368. https://doi.org/10.1002/(sici)1097-0142(19981001)83:7<1362::aid-cncr13>3.0.co;2-2
Warmuth, M. A., G. Bowen, L. R. Prosnitz, L. Chu, G. Broadwater, B. Peterson, G. Leight, and E. P. Winer. “Complications of axillary lymph node dissection for carcinoma of the breast: a report based on a patient survey.Cancer 83, no. 7 (October 1, 1998): 1362–68. https://doi.org/10.1002/(sici)1097-0142(19981001)83:7<1362::aid-cncr13>3.0.co;2-2.
Warmuth MA, Bowen G, Prosnitz LR, Chu L, Broadwater G, Peterson B, et al. Complications of axillary lymph node dissection for carcinoma of the breast: a report based on a patient survey. Cancer. 1998 Oct 1;83(7):1362–8.
Warmuth, M. A., et al. “Complications of axillary lymph node dissection for carcinoma of the breast: a report based on a patient survey.Cancer, vol. 83, no. 7, Oct. 1998, pp. 1362–68. Pubmed, doi:10.1002/(sici)1097-0142(19981001)83:7<1362::aid-cncr13>3.0.co;2-2.
Warmuth MA, Bowen G, Prosnitz LR, Chu L, Broadwater G, Peterson B, Leight G, Winer EP. Complications of axillary lymph node dissection for carcinoma of the breast: a report based on a patient survey. Cancer. 1998 Oct 1;83(7):1362–1368.
Journal cover image

Published In

Cancer

DOI

ISSN

0008-543X

Publication Date

October 1, 1998

Volume

83

Issue

7

Start / End Page

1362 / 1368

Location

United States

Related Subject Headings

  • Time Factors
  • Surveys and Questionnaires
  • Smoking
  • Radiotherapy
  • Postoperative Complications
  • Pain
  • Oncology & Carcinogenesis
  • Middle Aged
  • Medical Records
  • Lymph Node Excision