caa a22 4500 445335637 CHVBK 20180317142754.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1245/s10434-011-1688-1 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1688-1 Morbidity of Sentinel Node Biopsy: Relationship Between Number of Excised Lymph Nodes and Patient Perceptions of Lymphedema [Elektronische Daten] [Jessica Goldberg, Elyn Riedel, Monica Morrow, Kimberly Van Zee] Background: Sentinel lymph node biopsy (SLNB) is associated with reduced morbidity, although lymphedema remains a significant complication. Previously, we found no association between number of excised lymph nodes (LNs) and measured lymphedema in SLNB patients. In this analysis, we examined the relationship between number of LNs excised during SLNB and patient-perceived lymphedema. Methods: A total of 600 women who underwent SLNB for breast cancer were prospectively studied. Measured lymphedema was evaluated by circumferential bilateral upper-extremity measurements taken preoperatively and 3-8years postoperatively. Patient-perceived lymphedema was evaluated by interview at follow-up. The relationship between lymphedema, total LNs excised, and clinicopathologic variables was assessed with Fisher's exact test, Wilcoxon rank-sum test, kappa statistic, and McNemar's test. Results: At a median of 5years, 18 (3%) patients reported perceived lymphedema. More LNs were excised in patients with perceived lymphedema compared with those without (median, 5.5 vs. 3; p=0.01). Only 6 of 18 women with perceived lymphedema had objectively measured lymphedema (kappa=0.22). Patients with numbness more likely reported perceived lymphedema (p=0.03) and had more LNs excised (p=0.02). Women with surgery on the nondominant axilla were less likely to perceive arm swelling, regardless of the presence of measured lymphedema. Conclusions: After SLNB alone, patient-perceived lymphedema is uncommon, but its prevalence increases with more LNs excised. There is poor agreement between patient perceptions and objective measures. Our data suggest that factors other than limb enlargement, such as sensory nerve injury resulting from retrieval of more LNs and laterality of surgery, may play a significant role in patient perception of lymphedema after SLNB. Society of Surgical Oncology, 2011 Goldberg Jessica Breast Service, Department of Surgery, Evelyn H. Lauder Breast Center, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Riedel Elyn Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Morrow Monica Breast Service, Department of Surgery, Evelyn H. Lauder Breast Center, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Van Zee Kimberly Breast Service, Department of Surgery, Evelyn H. Lauder Breast Center, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut Annals of Surgical Oncology Springer-Verlag 18/10(2011-10-01), 2866-2872 1068-9265 18:10<2866 2011 18 10434 https://doi.org/10.1245/s10434-011-1688-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1688-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Goldberg Jessica Breast Service, Department of Surgery, Evelyn H. Lauder Breast Center, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Riedel Elyn Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Morrow Monica Breast Service, Department of Surgery, Evelyn H. Lauder Breast Center, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 700 1- Van Zee Kimberly Breast Service, Department of Surgery, Evelyn H. Lauder Breast Center, Memorial Sloan-Kettering Cancer Center, New York, NY, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/10(2011-10-01), 2866-2872 1068-9265 18:10<2866 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence SWISSBIB 445335637 BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer