A comparative Study for Lymphedema Following Formal Axillary Lymph Node Dissection Versus Lymphnode Sentinel Biopsy for Breast Cancer

Abstract

Background: Breast cancer treatment related lymphedema (BCRL) is associated with significant morbidities. To reduce the rate of BCRL, surgeons have changed the clinical practice in the surgical treatment of breast cancer, by performing sentinel lymph node biopsy (SLNB) instead of performing axillary lymph node dissection (ALND). Objective: The aim of this study is to compare and describe occurrence of lymphedema after complete axillary dissection versus sentinel lympnode biopsy in management of breast cancer. Methods: The present study is a prospective comparative study. It was conducted in the period from July, 2017 through June, 2018. The present study sought to compare using SLNB versus ALND in breast cancer patients in respect to occurrence of lymphedema. The study recruited 20 women indicated for modified radical mastectomy. They were equally and randomly allocated to one of the treatment groups: group I patients were subjected to ALND while group II patients were subjected to SLNB. Postoperatively, all patients were followed for lymphedema and related symptoms up to 6 months. Results: Comparison between the studied groups at baseline regarding age, BMI and pathological data revealed no statistically significant differences. In addition, there were no statistically significant differences between the studied groups regarding the preoperative arm circumference. Matching of the basic data assures that the study outcome would be probably attributed to the different surgical interventions. In the current study, comparison between the studied groups regarding the postoperative arm circumference higher arm circumference in GI patients which was short of statistical significance. However, the percent of arm circumference increase was significantly higher in GI patients. These differences were reflected in the significantly higher rate of lymphedema in GI patients as compared to GII patients (40.0 % versus 0.0 %, p=0.025). Conclusions: SLNB is associated with significantly lower rate of lymphedema