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乳腺癌患者腋窝淋巴结清扫与前哨淋巴结活检后生活质量及手臂不适的比较。

Comparison of quality of life and arm complaints after axillary lymph node dissection vs sentinel lymph node biopsy in breast cancer patients.

作者信息

Peintinger F, Reitsamer R, Stranzl H, Ralph G

机构信息

Gynecological Department, General Hospital Bruck/Leoben, Vordernbergerstrasse 42, 8700 Leoben, Austria. florentia.peintinger@;kh-leoben.at

出版信息

Br J Cancer. 2003 Aug 18;89(4):648-52. doi: 10.1038/sj.bjc.6601150.

Abstract

The sentinel lymph node biopsy (SLNB) represents a minimal invasive surgical method for axillary staging in patients with primary breast cancer. In a prospective study, evaluation of quality of life (QOL) and arm morbidity was performed before surgery on a total of 56 breast cancer patients. The EORTC QLQ-C30 and EORTC QLQ-BR23 questionnaires were used for QOL assessment. Assessment of pain was additionally observed using the McGill Pain Questionnaire. Arm mobility was observed by goniometric measurement of arm movement. Data were collected before surgery (t1), 1 week after discharge (t2) and 9-12 months after surgery (t3). The type of axillary surgery does not seem to affect global QOL at a short-time follow-up, but patients recover sooner after SLNB. Body image and sexual functioning remain stable in both types of axillary surgery. Arm/shoulder pain was reported in 36% of patients after SLNB in comparison to 68% receiving axillary lymph node dissection (ALND), and 'numbness' was reported only in 4% of patients in the SLNB group vs 19.3% after ALND. Abduction, flexion and horizontal adduction of the affected arm show significant impairment after ALND. Breast cancer patients should be counselled about the benefits of SLNB over ALND concerning QOL and postsurgery side effects in a short-term follow-up.

摘要

前哨淋巴结活检(SLNB)是一种用于原发性乳腺癌患者腋窝分期的微创手术方法。在一项前瞻性研究中,对总共56例乳腺癌患者在手术前进行了生活质量(QOL)评估和手臂并发症评估。使用欧洲癌症研究与治疗组织(EORTC)QLQ-C30和EORTC QLQ-BR23问卷进行生活质量评估。另外,使用麦吉尔疼痛问卷观察疼痛评估。通过角度测量手臂运动来观察手臂活动度。在手术前(t1)、出院后1周(t2)和手术后9至12个月(t3)收集数据。在短期随访中,腋窝手术类型似乎不影响总体生活质量,但前哨淋巴结活检术后患者恢复更快。两种腋窝手术类型的身体形象和性功能均保持稳定。前哨淋巴结活检术后36%的患者报告有手臂/肩部疼痛,而接受腋窝淋巴结清扫术(ALND)的患者中这一比例为68%,前哨淋巴结活检组仅4%的患者报告有“麻木”,而腋窝淋巴结清扫术后这一比例为19.3%。腋窝淋巴结清扫术后患侧手臂的外展、屈曲和水平内收均显示明显受损。对于乳腺癌患者,应就前哨淋巴结活检相对于腋窝淋巴结清扫术在短期随访中的生活质量和术后副作用方面的益处进行咨询。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3dba/2376906/983c48f6c4af/89-6601150f1.jpg

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