Impact of modern-day axillary treatment on patient reported arm morbidity and physical functioning in breast cancer patients.
Radiother Oncol
; 131: 221-228, 2019 02.
Article
em En
| MEDLINE
| ID: mdl-30033384
ABSTRACT
PURPOSE:
To reduce arm morbidity, routine axillary lymph node dissection (ALND) is often omitted or replaced by axillary radiotherapy (AxRT) in patients with limited nodal involvement. We evaluated patient-reported arm morbidity and physical functioning in breast cancer patients undergoing modern-day axillary treatment.METHODS:
All patients within the UMBRELLA cohort undergoing local radiotherapy with sentinel lymph node biopsy (SLNB), ALND and/or AxRT were selected. Patient-reported arm morbidity and physical functioning were assessed with EORTC QLQ C30/BR23 questionnaires up to eighteen months after initiation of radiotherapy. Patient-reported outcomes were compared between patients with SLNB only, ALND only, AxRT (level I-II), AxRT (level I-IV) or AxRT plus ALND by means of mixed model analysis.RESULTS:
In total, 949 patients were identified; 641 (68%) SLNB only, 57 (6%) ALND only, 94 (10%) AxRT level I-II, 72 (8%) AxRT level I-IV and 85 (9%) ALNDâ¯+â¯AxRT. SLNB only resulted in the least arm morbidity scores. ALNDâ¯+â¯AxRT resulted in most arm morbidity, with clinically relevant differences at 18â¯months. AxRT (level I-II or level I-IV) resulted in significantly less arm symptoms in the first 3â¯months compared to ALND. Arm symptom scores between those receiving AxRT on levels I-II and I-IV were similar.CONCLUSION:
Of all axillary management strategies, ALND plus AxRT is associated with worst patient-reported outcomes. AxRT resulted in less arm morbidity compared to ALND. Selective radiotherapy treatment of the axilla, i.e. radiotherapy of levels I-II only instead of levels I-IV, did not lead to clinically relevant reduced arm morbidity.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Braço
/
Neoplasias da Mama
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Linfonodos
Tipo de estudo:
Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Middle aged
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article