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Women Undergoing Sentinel Lymph Node Biopsy Sometimes Get the Blues: Presented at SSO

By Carole Bullock

CHICAGO -- March 24, 2008 -- Women undergoing sentinel lymph node biopsy (SLNB) will face a decline in their quality of life (QoL), but usually recover by 2 years postprocedure, researchers reported here at the Society of Surgical Oncology (SSO) 61st Annual Cancer Symposium.

Patients who undergo SLNB report better role, cognitive, and social functioning than do patients who undergo axillary lymph node dissection (ALND), reported Harald J. Hoekstra, MD, Professor, Division of Surgical Oncology, Department of Surgical Oncology, University Medical Centre Groningen, Groningen, Netherlands.

"Two years postsurgery, breast cancer patients' quality of life is comparable with that of shortly before surgery. Women rated their emotional functioning as even better than before surgery," Dr. Hoekstra said.

He added that SLNB is not associated with a better quality of life than ALND, but systemic therapy and/or complications affect QoL negatively.

Dr. Hoekstra and colleagues conducted their study to gain insight into short-term and long-term treatment-related morbidity in breast cancer patients, he said in an interview on March 15.

The researchers explored QoL and recovery among women diagnosed with breast cancer because "little is known about how the surgeries affect women in their daily lives," he added.

The prospective, longitudinal, 2-year study included 175 patients with stage I/II breast cancer. Of these, 54 patients underwent SLNB, 56 underwent SLNB plus ALND, and 65 underwent ALND. The mean age of the cohort was 55 years. Subjects completed the Eastern European Organisation for Research and Treatment of Cancer functional QoL questionnaire at all assessments -- 1 day before surgery (T0), and 6 (T1), 26 (T2), 52 (T3), and 104 (T4) weeks after surgery.

Researchers computed the General Linear Models and paired t tests between T0 to T4 and T1 to T4. Complications, radiotherapy, and systemic therapy were added to the model.

Results showed significant time effects on physical, role, and emotional functioning. Physical and role functioning scores decreased from T0 to T1. At T4, patients in the SLNB group had increases in functioning to their T0 levels; ALND patients' functioning had increased, but had not improved to their T0 levels.

Emotional functioning increased linearly between T0 and T4. At T4, emotional functioning was significantly higher in all groups compared with their T0 levels. No significant group or interaction (timeXgroup) effects were found.

Complications and chemotherapy had a negative significant effect on role, emotional, and cognitive functioning.

Complications also had a significant effect on social functioning. Effect sizes varied between 0.00 and 0.06.


[Presentation title: Quality of Life After Sentinel Lymph Node Biopsy or Axillary Lymph Node Dissection in Stage I/II Breast Cancer Patients: A Prospective Longitudinal Study. Abstract 88]

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