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A Journal on Internal Medicine

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,6

Frequency: Quarterly

ISSN 0031-0808

Online ISSN 1827-1898


Panminerva Medica 2001 June;43(2):103-7


Impact of axillary level I and II lymphnode dissection on the therapy of stage I and II breast cancer

Tocchi A., Mazzoni G., Bettelli E., Miccini M., Giuliani A., Cassini D.

From the 1st Department of Surgery University of Rome «La Sapienza», Rome, Italy

Background. Routine per­for­mance of axil­lary ­node dis­sec­tion (AND) in the treat­ment of ­stage I and II ­breast ­cancer has ­become con­tro­ver­sial ­because of pre­tended mor­bidity of ­this pro­ce­dure and pro­gressing con­sent for sen­tinel lym­phad­e­nec­tomy.
Methods. Ninety-­four con­sec­u­tive ­patients who under­went AND for clin­ical ­stage I and II ­breast ­cancer ­were eval­u­ated for a ­range of 48.3 ­months ­after sur­gery for move­ment and sen­sory alter­a­tions and arm ­swelling. Arm cir­cum­fer­ence was meas­ured in all ­patients at the ­same ­four ­sites on ­both the oper­ated and non oper­ated ­sides pre­op­er­a­tively and in the imme­diate and ­late post­op­er­a­tive ­course. Capacity for move­ment ­was ­assessed pre- and post­op­er­a­tively as ­active ­ranging at the ­shoulder ­joint. Postoper­a­tive numb­ness and pares­the­sias ­were ­assessed by stan­dard ques­tions.
Results. No ­patient had axil­lary recur­rence. None of the ­detected dif­fer­ences ­between the preoper­a­tive and ­postoper­a­tive arm cir­cum­fer­ences ­reached sta­tis­tical sig­nif­i­cance. No per­sis­tent ­motion lim­i­ta­tion was ­observed. Pain, numb­ness, pares­thesia ­were ­detected in ­almost all ­patients in the imme­diate post­op­er­a­tive ­period but ­resolved spon­ta­ne­ously in all ­cases ­within 6 ­months. The ­obese ­body ­habit was ­detected on mul­ti­var­iate anal­ysis as the ­only sig­nif­i­cant pre­dictor of ­edema.
Conclusions. No sig­nif­i­cant mor­bidity and no axil­lary recur­rence ­were ­observed in cur­rent expe­ri­ence to ­follow AND. These find­ings sug­gest ­that axil­lary ­level I and II dis­sec­tion ­remains an effec­tive and ­safe ­tool for diag­nostic, as ­well ther­a­peutic, pur­poses in the treat­ment of ­stage I and II ­breast ­cancer. Further ­studies are nec­es­sary ­before it can ­safely be reported ­that axil­lary ­node dis­sec­tion is an ­optional ­part of the treat­ment of ­stage I and II ­breast ­cancer.

language: English


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