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Randomized Controlled Trial
. 2010 Aug 1;102(2):111-8.
doi: 10.1002/jso.21535.

Morbidity results from the NSABP B-32 trial comparing sentinel lymph node dissection versus axillary dissection

Takamaru Ashikaga  1 , David N Krag, Stephanie R Land, Thomas B Julian, Stewart J Anderson, Ann M Brown, Joan M Skelly, Seth P Harlow, Donald L Weaver, Eleftherios P Mamounas, Joseph P Costantino, Norman Wolmark; National Surgical Adjuvant Breast, Bowel Project
Affiliations
Randomized Controlled Trial

Morbidity results from the NSABP B-32 trial comparing sentinel lymph node dissection versus axillary dissection

Takamaru Ashikaga et al. J Surg Oncol. .

Abstract

Background and objectives: Three year post-surgical morbidity levels were compared between patients with negative sentinel lymph node dissection alone (SLND) and those with negative sentinel node dissection and negative axillary lymph node dissection (ALND) in the NSABP B-32 trial.

Methods: A total of 1,975 ALND and 2,008 SLND node negative breast cancer patients had shoulder range of motion and arm volumes assessed along with self reports of arm tingling and numbness. Relative shoulder abduction deficits and relative arm volume differences between ipsilateral and contralateral arms were calculated.

Results: Shoulder abduction deficits >or=10% peaked at 1 week for the ALND (75%) and SLND (41%) groups. Arm volume differences >or=10% at 36 months were evident for the ALND (14%) and SLND (8%) groups. Numbness and tingling peaked at 6 months for the ALND (49%, 23%) and SLND (15%, 10%) groups. Logistic regression correlates of residual morbidity included treatment group, age, handedness, tumor size, systemic chemotherapy, and radiation to the axilla.

Conclusions: Although residual morbidity for both treatment groups was evident, the results of the NSABP B-32 study indicate the superiority of the SLND compared to the ALND treatment approach relative to post-surgical morbidity outcomes over a 3-year follow-up period.

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Figures

Figure 1
Figure 1
Flow diagram with randomization schema of the B-32 trial. Asterisk indicates that in this group, patients in whom a sentinel lymph node was not identified received an axillary lymph node dissection.
See this image and copyright information in PMC

Comment in

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