Use of Sentinel Lymph Node Biopsy and Early Physiotherapy to Reduce Incidence of Lymphedema After Breast Cancer Surgery: an Institutional Experience

Sandhya Gupta; Neerja Gupta; Geeta Kadayaprath; Smriti Neha

doi:10.1007/s13193-019-01030-4

Use of Sentinel Lymph Node Biopsy and Early Physiotherapy to Reduce Incidence of Lymphedema After Breast Cancer Surgery: an Institutional Experience

Indian J Surg Oncol. 2020 Mar;11(1):15-18. doi: 10.1007/s13193-019-01030-4. Epub 2020 Jan 7.

Authors

Sandhya Gupta¹, Neerja Gupta², Geeta Kadayaprath³, Smriti Neha⁴

Affiliations

¹ Breast unit, Dept of Surgical Oncology, MICC, A-14, SRM Apartment, IP Extension, Patparganj, New Delhi, 110092 India.
² Breast Unit, Dept of Surgical Oncology, MICC, Flat no. 73 C, Pocket C1A, Janakpuri, New Delhi, 110058 India.
³ Breast Unit, Dept of Surgical Oncology, MICC, 114, Supreme Enclave, Mayur Vihar Phase 1, New Delhi, 110091 India.
⁴ 4Dept of Physiotherapy Max Healthcare, Flat 124, Samrat Apartment, Vasundhara Enclave, New Delhi, 110096 India.

Abstract

Newer advances in breast cancer management have led to increased disease free survival and overall survival. It is important to prevent debilitating complications after axillary lymph node dissection (ALND) to be able to successfully translate this survival benefit to quality of life benefit. By reducing disruption of lymphatic channels, sentinel lymph node biopsy (SLNB) decreases incidence of lymphedema (LE). Initiating early physiotherapy regimens, too, improves arm symptoms. In this review, we analyze the incidence of LE at our center and compare it with western literature. Retrospective analysis of all post-surgery breast cancer 18 patients, who followed up routinely with our oncophysiotherapist, was carried out. Incidence of LE in patients undergoing SLNB or ALND was followed up for a mean period of 17.5 months. Only 3.6%, i.e., 6 patients out of 166 developed LE. Amongst 166, 80 had only SLNB; the rest had ALND (either upfront or post-positive SLNB). None of the SLNB only cohort patients developed LE. SLNB in clinically node negative axilla, followed by initiation of arm physiotherapy early in post-operative period, may reduce LE incidence in breast cancer patients.

Keywords: Breast cancer; Early physiotherapy; Lymphedema; Rehabilitation; SLNB.