The complication comparing between sentinel lymph node biopsy and axillary lymph node dissection in non-metastatic lymph node early breast cancer
Keywords:
early breast cancer, sentinel lymph node biopsy, non-oncological outcomeAbstract
Background: There is acceptance of sentinel lymph node biopsy as a prognostic tool in early breast cancer patients. In Nakornping Hospital has been implemented since 2017 but no non-oncologic outcome has been reported.
Objective: The aim of this study was to compare non-oncologic complications such as pain, numbness, seroma, lymphedema, shoulder stiffness, abnormal shoulder movement, length of hospital stay, and overall complications between sentinel lymph node biopsy (SLNB) and axillary lymph node dissection (ALND) in early-stage breast cancer with non-metastatic lymph nodes.
Material and method: A retrospective cohort study collected from a single tertiary, referral hospital, Nakornping Hospital from January 1st, 2017 – January 1st, 2020. We included female patients with confirmed diagnosis of clinical non-metastatic lymph node early breast cancer, received breast surgery and complete pathological reports. The patients’ data were analyzed non-oncologic outcomes, comparison of surgery between sentinel lymph node biopsy and axillary lymph node dissection.
Results: From a total of 80 patients, 28 patients in sentinel lymph node biopsy group, and 52 patients in axillary lymph node dissection group. The results showed that the patients in sentinel lymph node biopsy group had better outcome in lesser pain (adjusted OR 0.08 (95%Cl=0.01-0.50), p=0.007), numbness (adjusted OR 0.05 (95%Cl=0.01-0.19), p<0.001), lymphedema (adjusted OR 0.05 (95%Cl=0.05-0.46), p=0.008), shoulder stiffness (adjusted OR 0.03 (95%Cl=0.01-0.35), p=0.005) and abnormal shoulder movement (adjusted OR 0.07 (95%Cl=0.02-0.29), p<0.001). The sentinel lymph node biopsy group was decrease in length of hospital stay compared to the axillary lymph node dissection group (7.14±3.44 days vs 9.87±3.92 days (p=0.003)). The overall complications were 15 patients (53.6%) in sentinel lymph node biopsy group and 43 patients (82.7%) in axillary lymph node dissection group (p=0.008). There were no significant difference between seroma formation between both groups SLNB 39.3% vs ALND 40.4% (adjusted OR 1.17 (95%Cl=0.40-3.37), p=0.774).
Conclusion: The sentinel lymph node biopsy is associated with less hospital stay and fewer overall complications compared to the axillary lymph node dissection in patients with non-metastatic lymph node early breast cancer.
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