Association between Number of Retrieved Sentinel Lymph Nodes and Breast Cancer-related Lymphedema

김홍규; 주영욱; 이준우; 김경은; 정지광; 김유미; 이한별; 문형곤; 노동영; 서관식; 한원식

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자료유형: 학술저널

저자정보: 김홍규 (Department of Surgery Seoul National University College of Medicine Seoul Korea; Department of Surg) 주영욱 (Department of Surgery Seoul National University College of Medicine Seoul Korea) 이준우 (Department of Surgery Ewha Womans University Medical Center Seoul Korea) 김경은 (Pusan National University Hospital Busan Cancer Center Busan Korea) 정지광 (Department of Surgery Seoul National University College of Medicine Seoul Korea) 김유미 (Department of Surgery Seoul National University College of Medicine Seoul Korea) 이한별 (Department of Surgery Seoul National University College of Medicine Seoul Korea) 문형곤 (Department of Surgery Seoul National University College of Medicine Seoul Korea; Cancer Research In) 노동영 (Department of Surgery Seoul National University College of Medicine Seoul Korea; Cancer Research In) 서관식 (Department of Rehabilitation Medicine Seoul National University College of Medicine Seoul Korea) 한원식 (Department of Surgery Seoul National University College of Medicine Seoul Korea; Cancer Research In)

저널정보: 한국유방암학회 Journal of Breast Cancer Journal of Breast Cancer Vol.24 No.1

발행연도: 2021.1

수록면: 63 - 74 (12page)

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Purpose: Sentinel lymph node biopsy (SLNB) has become a standard axillary staging surgery for early breast cancer, and the proportion of patients requiring axillary lymph node dissection (ALND) is decreasing. We aimed to evaluate the association between the number of sentinel lymph nodes (SLNs) retrieved and the risk of lymphedema of the ipsilateral arm. Methods: Prospectively collected medical records of 910 patients were reviewed. Lymphedema was defined as a difference in circumference > 2 cm compared to the contralateral arm and/or having clinical records of lymphedema treatment in the rehabilitation clinic. Results: Together with an objective and subjective assessment of lymphedema, 36 patients (6.1%) had lymphedema in the SLNB group and 85 patients (27.0%) had lymphedema in the ALND group (p < 0.001). In a multivariate analysis of the whole cohort, risk factors significantly associated risk with the development of lymphedema were body mass index, mastectomy (vs. breast-conserving surgery), ALND, and radiation therapy. In logistic regression models in the SLNB group only, there was no correlation between the number of retrieved SLNs and the incidence of lymphedema. In addition, in the Pearson correlation analysis, no correlation was observed between the number of retrieved SLNs and the difference in circumference between the ipsilateral and contralateral upper extremities (correlation coefficients = 0.067, p = 0.111). Conclusion: The risk of lymphedema in breast cancer surgery and adjuvant treatments is multifactorial. The number of retrieved lymph nodes during sentinel biopsy was not associated with the incidence of lymphedema.

#Breast neoplasms #Lymphedema #Sentinel lymph node biopsy

참고문헌 (30)

참고문헌 신청

Hayes SC / 2008 / Lymphedema after breast cancer: incidence, risk factors, and effect on upper body function / J Clin Oncol 26:3536~3542

McLaughlin SA / 2017 / Considerations for clinicians in the diagnosis, prevention, and treatment of breast cancer-related lymphedema:recommendations from a multidisciplinary expert ASBrS panel : part 1: definitions, assessments, education, and future directions / Ann Surg Oncol 24:2818~2826

Goldberg JI / 2010 / Morbidity of sentinel node biopsy in breast cancer : the relationship between the number of excised lymph nodes and lymphedema / Ann Surg Oncol 17:3278~3286

Giuliano AE / 2017 / Effect of axillary dissection vs no axillary dissection on 10-year overall survival among women with invasive breast cancer and sentinel node metastasis : the ACOSOG Z0011(Alliance)randomized clinical trial / JAMA 318:918~926

Galimberti V / 2013 / Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases(IBCSG 23-01) : a phase 3 randomised controlled trial / Lancet Oncol 14:297~305

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