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Arm lymphoedema after axillary surgery in women with invasive breast cancer
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2014 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 101, no 4, 390-397 p.Article in journal (Refereed) Published
Abstract [en]

BackgroundThe primary aim was to compare arm lymphoedema after sentinel lymph node biopsy (SLNB) alone versus axillary lymph node dissection (ALND) in women with node-negative and node-positive breast cancer. The secondary aim was to examine the potential association between self-reported and objectively measured arm lymphoedema. MethodsWomen who had surgery during 1999-2004 for invasive breast cancer in four centres in Sweden were included. The study groups were defined by the axillary procedure performed and the presence of axillary metastases: SLNB alone, ALND without axillary metastases, and ALND with axillary metastases. Before surgery, and 1, 2 and 3years after operation, arm volume was measured and a questionnaire regarding symptoms of arm lymphoedema was completed. A mixed model was used to determine the adjusted mean difference in arm volume between the study groups, and generalized estimating equations were employed to determine differences in self-reported arm lymphoedema. ResultsOne hundred and forty women had SLNB alone, 125 had node-negative ALND and 155 node-positive ALND. Women who underwent SLNB had no increase in postoperative arm volume over time, whereas both ALND groups showed a significant increase. The risk of self-reported arm lymphoedema 1, 2 and 3years after surgery was significantly lower in the SLNB group compared with that in both ALND groups. Three years after surgery there was a significant association between increased arm volume and self-reported symptoms of arm lymphoedema. ConclusionSLNB is associated with a minimal risk of increased arm volume and few symptoms of arm lymphoedema, significantly less than after ALND, regardless of lymph node status. Minimal after sentinel node biopsy

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2014. Vol. 101, no 4, 390-397 p.
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URN: urn:nbn:se:uu:diva-227912DOI: 10.1002/bjs.9401ISI: 000331453900012OAI: oai:DiVA.org:uu-227912DiVA: diva2:731639
Available from: 2014-07-02 Created: 2014-07-01 Last updated: 2014-07-02Bibliographically approved

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Bergkvist, Leif
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Centre for Clinical Research, County of VästmanlandDepartment of Surgical Sciences
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