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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2006

01-04-2006

Surgical Complications Associated With Sentinel Lymph Node Biopsy: Results From a Prospective International Cooperative Group Trial

Authors: Lee Gravatt Wilke, MD, Linda M. McCall, MS, Katherine E. Posther, MD, Pat W. Whitworth, MD, Douglas S. Reintgen, MD, A. Marilyn Leitch, MD, Sheryl G. A. Gabram, MD, Anthony Lucci, MD, Charles E. Cox, MD, Kelly K. Hunt, MD, James E. Herndon II, PhD, Armando E. Giuliano, MD

Published in: Annals of Surgical Oncology | Issue 4/2006

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Abstract

Background

American College of Surgeons Oncology Group Z0010 is a prospective multicenter trial designed to evaluate the prognostic significance of micrometastases in the sentinel lymph nodes and bone marrow aspirates of women with early-stage breast cancer. Surgical complications associated with the sentinel lymph node biopsy surgical procedure are reported.

Methods

Eligible patients included women with clinical T1/2N0M0 breast cancer. Surgical outcomes were available at 30 days and 6 months after surgery for 5327 patients. Patients who had a failed sentinel node mapping (n = 71, 1.4%) or a completion lymph node dissection (n = 814, 15%) were excluded. Univariate and multivariate analyses were performed to identify predictors for the measured surgical complications.

Results

In patients who received isosulfan blue dye alone (n = 783) or a combination of blue dye and radiocolloid (n = 4192), anaphylaxis was reported in .1% of subjects (5 of 4975). Other complications included axillary wound infection in 1.0%, axillary seroma in 7.1%, and axillary hematoma in 1.4% of subjects. Only increasing age and an increasing number of sentinel lymph nodes removed were significantly associated with an increasing incidence of axillary seroma. At 6 months, 8.6% of patients reported axillary paresthesias, 3.8% had a decreased upper extremity range of motion, and 6.9% demonstrated proximal upper extremity lymphedema (change from baseline arm circumference of >2 cm). Significant predictors for surgical complications at 6 months were a decreasing age for axillary paresthesias and increasing body mass index and increasing age for upper extremity lymphedema.

Conclusions

This study provides a prospective assessment of the sentinel lymph node biopsy procedure, as performed by a wide range of surgeons, demonstrating a low complication rate.
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Metadata
Title
Surgical Complications Associated With Sentinel Lymph Node Biopsy: Results From a Prospective International Cooperative Group Trial
Authors
Lee Gravatt Wilke, MD
Linda M. McCall, MS
Katherine E. Posther, MD
Pat W. Whitworth, MD
Douglas S. Reintgen, MD
A. Marilyn Leitch, MD
Sheryl G. A. Gabram, MD
Anthony Lucci, MD
Charles E. Cox, MD
Kelly K. Hunt, MD
James E. Herndon II, PhD
Armando E. Giuliano, MD
Publication date
01-04-2006
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 4/2006
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/ASO.2006.05.013

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