Impact of axillary level I and II lymphnode dissection on the therapy of stage I and II breast cancer

Background. Routine performance of axillary node dissection (AND) in the tr eatment of stage I and II breast cancer has become controversial because of pretended morbidity of this procedure and progressing consent for sentinel lymphadenectomy. Methods. Ninety-four consecutive patients who underwent AND for clinical st age I and II breast cancer were evaluated for a range of 48.3 months after surgery for movement and sensory alterations and arm swelling. Arm circumfe rence was measured in all patients at the same four sites on both the opera ted and non operated sides preoperatively and in the immediate and late pos toperative course. Capacity for movement was assessed pre- and postoperativ ely as active ranging at the shoulder joint. Postoperative numbness and par esthesias were assessed by standard questions. Results. No patient had axillary recurrence. None of the detected differenc es between the preoperative and postoperative arm circumferences reached st atistical significance. No persistent motion limitation was observed. Pain, numbness, paresthesia were detected in almost all patients in the immediat e postoperative period but resolved spontaneously in all cases within 6 mon ths. The obese body habit was detected on multivariate analysis as the only significant predictor of edema. Conclusions. No significant morbidity and no axillary recurrence were obser ved in current experience to follow AND. These findings suggest that axilla ry level I and II dissection remains an effective and safe tool for diagnos tic, as well therapeutic, purposes in the treatment of stage I and II breas t cancer. Further studies are necessary before it can safely be reported th at axillary node dissection is an optional part of the treatment of stage I and II breast cancer.