84 (PB-084) Poster - Quality of life and lymphedema incidence after axillary surgery in pN1 breast cancer patients: lymphadenectomy vs. Sentinel lymph node biopsy

Abstract

Introduction: In the last decade, there has been a paradigm shift in axillary management in patients with breast cancer: the possibility of avoiding axillary lymph node dissection (ALND) in a specific group of breast cancer patients with axillary disease, to decrease the axillar surgery-related morbidity. Objectives: To Assess the impact on the quality of life (QoL) of ALND vs. Sentinel lymph node dissection (SLN) associated with radiotherapy for patients with node-positive breast cancer. To Appraise the incidence of lymphedema after axillary treatment in both groups. Methods: Retrospective observational study of surgery patients with node-positive breast cancer (pN1), at a university center from 2018 to 2019. In addition, a cross-sectional study was performed between May to July 2022 to assess the incidence of arm lymphedema measured by circometry and appraise QoL. We use the QLQ-BR23 questionnaire to assess the general QoL, and ULL-27 questionnaire to appraise the specific QoL scale in upper limb lymphedema, both for Spanish population. Results: 114 patients completed the questionnaires and measurements: 68 ALND patients and 46 SLN, with 40.8 months postoperative follow-up. The scores on both questionnaires were similar in all dimensions explored in both groups of patients, without significant clinical or statistical differences. In the lymphadenectomy group, the incidence of lymphedema was higher (32.4% vs 10.9%; p = 0.006). The QoL of lymphedema patients were globally similar than no lymphedema patients, but the QoL of symptomatic lymphedema was worse (BR-23: perspective dimension 56.9 vs 72.4, p = 0.002; sexual function 61.6 vs 77.9 p = 0.002 and ULL-27 (best 0 worse 100): physical dimension 37.8 vs 19.1 p = 0.003). Conclusions. The axillary node dissection does not produce a significant impact on the quality of life of patients with breast cancer and axillary involvement, despite developing lymphedema more frequently. The symptomatic lymphedema patients have worse quality of life. No conflict of interest.