ARM MORBIDITY FOLLOWING TREATMENT OF BREAST-CANCER WITH TOTAL AXILLARY DISSECTION - A MULTIVARIATED APPROACH

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 %.