COMPLETE VERSUS SELECTIVE AXILLARY DISSECTION AFTER LYMPH NODE MAPPING IN TREATMENT OF EARLY CANCER BREAST

Abstract

Background: Lymphedema is a condition that is feared by many breast cancer patients
because of its irreversible nature, its associated negative body image, lower self-reported
quality of life scores, sleeping disturbance, difficulty carrying objects and completing daily
activities, and physical discomfort.
Methods: The study included 40 female patients with operable breast cancer (stage I and II).
The forty patients were divided into two groups: Group I: included twenty patients (50%) who
underwent modified radical mastectomy or radical conservative breast surgery together with
axillary lymph node mapping (which means selective axillary dissection).Group II: included
the other twenty patients (50%) who underwent modified radical mastectomy or radical
conservative breast surgery without performing axillary lymph node mapping (which means
complete axillary dissection.
Results: identification of blue lymph nodes was achieved in 11 patients from group I (55%)
and could be preserved in 7 patients (63.6%) and excised in 4 patients (36.4%). Lymphedema
developed in 3 patients from group I and 7 patients from group II. Lymphedema developed in
one patient with preserved blue lymph nodes.
Conclusion: chronic upper limb lymphedema is statistically significantly less with selective
axillary dissection (mapping of axillary lymph nodes) in comparison to complete axillary
dissection (no mapping).
Key words: axillary dissection, breast cancer, lymph node mapping, methylene blue dye