Long-term quality of life in patients with breast cancer according to sentinel lymph node biopsy or axillary lymph node dissection: A multicenter cohort study with 6 years follow-up.

Abstract

1114 Background: the aim of this study was to assess long term quality of life (QoL) over a period of 6 years in women with a breast cancer (BC) who underwent sentinel lymph node biopsy (SLNB), axillary lymph node dissection (ALND), or SLNB followed by ALND. Methods: The EORTC-QLQ-C30 and the EORTC-QLQ-BR-23 questionnaires were used to assess QoL before surgery, just after surgery, 6, 12 and 72 months later. The Kruskal Wallis test with the Bonferroni correction was used to compare scores. A mixed model analysis of variance for repeated measurements was then applied to assess the longitudinal effect of surgical modalities on QoL. Results: Five hundred and eighteen BC patients were initially included. The median follow-up was 6 years. During the follow-up, 61 patients died. None of the patients of the SLNB group has developed lymphedema during follow-up and the relapse rate was not different between the different groups (p=0.62). Before surgery, global health (GHS) (P = 0.5226) and arm symptoms (BRAS) (P = 0.9902) QoL scores were similar whatever the surgical procedure. BRAS score (p=0.0001) was better in the SNLB group 72 months after surgery. Moreover, compared to ALND patients, patients treated with SLNB had fewer arm symptoms with the follow-up. In addition, body image (P = 0.0005), upset by hair loss (P = 0.0045), systemic therapy side effects (P = 0.0097) and future perspective (P = 0.0375) QoL dimensions remained better 5 to 6 years after diagnosis in patients treated by SLNB. Conclusions: Long term follow-up showed that, SLNB is a safe and acceptable accurate method associated with less morbidity than ALND.