A. Keramopoulos et al., ARM MORBIDITY FOLLOWING TREATMENT OF BREAST-CANCER WITH TOTAL AXILLARY DISSECTION - A MULTIVARIATED APPROACH, Oncology, 50(6), 1993, pp. 445-449
In order to clarify the factors that mainly influence arm morbidity fo
llowing treatment of breast cancer with the full axillary dissection p
rotocol, we evaluated, in a model of multiple regression analysis, par
ameters such as the type of breast surgery, adjuvant radiotherapy, tim
e of irradiation, age, number of dissected nodes and axillary nodal st
atus. A total of 104 women were studied. Late arm edema was observed i
n 17% of the patients and was more frequent when (1) irradiation was g
iven immediately after the operation than if it was given 6 months lat
er (p = 0.009) and (2) the number of removed nodes exceeded 40 (p = 0.
037). Upper limb pain was reported by 16% of the patients and was repo
rted more frequently from patients over 60 years of age (p = 0.036), a
s well as from patients who underwent modified radical mastectomy (p =
0.044) and those in whom 30-40 nodes were dissected (p = 0.025). Shou
lder joint mobility was impaired in 17% of the patients, and it was no
t affected by any of the examined factors. It seems that conservative
breast surgery or adjuvant breast radiotherapy 6 months after the oper
ation might reduce independently the likelihood of arm morbidity by 25
%.