Morbidade entre a pós-biópsia de linfonodo sentinela e a dissecção axilar no câncer de mama

Abstract

BACKGROUND. The aim of this study was to evaluate the morbidity after sentinel node biopsy (SNB) and axillary dissection with (AD-NS) or without sparing the intercostobrachial nerve (AD-NOS). Methods: A prospective cohort study was performed on 108 patients divided into three groups: SNB (n=35), AD-NS (n=36) and AD-NOS (n=37). We evaluated the incidence of sensory loss, pain, lymphedema, seroma formation and infection in the arm homolateral to the breast surgery. Semmes-Weinstein monofilaments were used to assess the sensory loss; brachial perimetry was used to evaluate presence of lymphedema and a pain questionnaire was administered. ANOVA and Kruskal-Wallis statistical tests were used. Bivariate and Multivariate analyses were performed. RESULTS. After surgery at least one complication was reported by 45/ 108 (41.7%) patients. Pain was the outcome more often reported by patients. In the three groups a significant difference was observed only regarding sensory loss (p=0.04). Pain, lymphedema, and sensory loss were more frequently found in the AD-NOS group. No significant difference was observed between SNB and AD-NS groups. Semmes-Weinstein monofilaments showed preservation of cutaneous sensitivity in 28/35 patients from the SNB group, in 25/36 patients from AD-NS group but in only 10/37 patients from AD-NOS group (p<0.001). CONCLUSION. The ICB section is associated with higher sensory loss, with statistically significant difference between the groups that were not shown to be significant with the others complications.