Baron Roberta H, Fey Jane V, Borgen Patrick I, Stempel Michelle M, Hardick Kathleen R, Van Zee Kimberly J
Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, New York 10021, USA.
Ann Surg Oncol. 2007 May;14(5):1653-61. doi: 10.1245/s10434-006-9334-z. Epub 2007 Feb 13.
The aim of this study is to evaluate prevalence, severity, and level of distress of 18 sensations at baseline (3-15 days) and 5 years after breast cancer surgery, and compare sensations after sentinel lymph node biopsy (SLNB) with those after SLNB plus immediate or delayed axillary lymph node dissection (ALND).
A total of 187 patients with breast cancer completed the Breast Sensation Assessment Scale at baseline and at 3, 6, 12, 24, and 60 months after surgery to assess prevalence, severity, and level of distress of sensations. Of these, 133 had SLNB, and 54 had SLNB and ALND. Additionally, of the 187 patients, 141 had breast-conservation therapy and 46 had total mastectomy.
Sensations were less prevalent, severe, and distressing after SLNB compared with ALND at baseline and at 5 years. This difference was most evident in those who had breast-conservation therapy. Most sensations after SLNB and ALND, even if prevalent, were not severe or distressing. Some sensations remained notably prevalent at 5 years, including tenderness and twinges after SLNB, and tightness and numbness after ALND. Phantom sensations were frequently reported by mastectomy patients.
Prevalence, severity, and level of distress of sensations were lower after SLNB compared with ALND, but some morbidity existed after SLNB. Certain sensations remained highly prevalent in both groups for up to 5 years.
本研究旨在评估乳腺癌手术后基线期(3 - 15天)及5年后18种感觉的发生率、严重程度和困扰程度,并比较前哨淋巴结活检(SLNB)后与SLNB加即时或延迟腋窝淋巴结清扫(ALND)后的感觉。
共有187例乳腺癌患者在基线期以及术后3、6、12、24和60个月完成了乳房感觉评估量表,以评估感觉的发生率、严重程度和困扰程度。其中,133例行SLNB,54例行SLNB及ALND。此外,187例患者中,141例行保乳治疗,46例行全乳切除术。
在基线期和5年时,与ALND相比,SLNB后的感觉发生率、严重程度和困扰程度更低。这种差异在接受保乳治疗的患者中最为明显。SLNB和ALND后的大多数感觉,即使发生率较高,也并不严重或令人困扰。有些感觉在5年时仍明显普遍存在,包括SLNB后的压痛和刺痛,以及ALND后的紧绷感和麻木感。乳房切除患者经常报告有幻肢感。
与ALND相比,SLNB后的感觉发生率、严重程度和困扰程度更低,但SLNB后仍存在一些并发症。两组中某些感觉在长达5年的时间里仍然非常普遍。