Short-term morbidity of the upper limb after sentinel lymph node biopsy or axillary lymph node dissection for Stage I or II breast carcinoma

Cancer. 2003 Aug 15;98(4):690-6. doi: 10.1002/cncr.11545.


Background: The goals of sentinel lymph node biopsy (SLNB) are to improve axillary staging and reduce unnecessary axillary lymph node dissections (ALND), thereby reducing treatment-related upper-limb morbidity. In the current prospective study, short-term upper-limb morbidity was assessed after SLNB and/or ALND.

Methods: The study comprised 204 patients with Stage I/II breast carcinoma. Mean patient age was 55.6 years (standard deviation, 11.6). Sixty-six patients (32%) underwent SLNB only, and 138 (68%) underwent a Level I-II ALND. Assessment (preoperative [t0] and 6 weeks postoperative [t1]) included evaluation of shoulder range of motion, muscle strength, grip strength, pain, upper/forearm circumference, shoulder disability, and activities of daily life (ADL).

Results: Considerable treatment-related upper-limb morbidity was observed. Significant (P < 0.001) changes were found for pain, range of motion in forward flexion, abduction and abduction/external rotation, strength of shoulder abductors and elbow flexors, and in perceived disability in ADL. However, no significant difference in change of upper-limb function and ADL was found between the SLNB and ALND groups.

Conclusions: Significant short-term treatment-related upper-limb morbidity exists after SLNB or ALND. There is no significant difference in short-term treatment-related morbidity between SLNB and ALND.

Publication types

  • Comparative Study

MeSH terms

  • Activities of Daily Living
  • Arm* / physiopathology
  • Axilla
  • Breast Neoplasms / pathology*
  • Breast Neoplasms / surgery
  • Edema / etiology
  • Female
  • Hand Strength
  • Humans
  • Lymph Node Excision / adverse effects*
  • Middle Aged
  • Movement
  • Pain / etiology
  • Prospective Studies
  • Range of Motion, Articular
  • Sentinel Lymph Node Biopsy / adverse effects*
  • Shoulder Joint / physiopathology
  • Surveys and Questionnaires