Identifying the “sentinel lymph nodes” for arm drainage as a strategy for minimizing the lymphedema risk after breast cancer therapy

Excerpt

Lymphedema is one of the most dreaded complications of breast cancer therapy which often results in physical discomfort, psychological distress, functional impairment, change in body habitus and self-image, chronic disability, and diminished quality of life [1‐7]. In addition, lymphedema management generates significant financial costs to the affected individual and to national and international health care delivery systems [8]. Accordingly, a number of strategies have been developed to help minimize the risk of this complication. Foremost amongst these advances has been the development of sentinel lymph node dissection for breast cancer patients with clinically negative lymph nodes. This technology has allowed surgeons to identify the first echelon of lymph nodes that drain the breast. Studies have indicated that if no disease is found within the sentinel lymph nodes, the probability of finding disease in other axillary lymph nodes is very low. As such, sentinel lymph node surgery without a dissection has become recognized as an appropriate standard-of-care and a less morbid alternative to the historical standard of an axillary dissection (surgical removal of level I and II of the axilla). …