The impact of the sentinel node concept on the aesthetic outcome of breast cancer conservative surgery

Abstract

The sentinel node (SN) concept has brought numerous advantages to women with breast cancer. Sparing axillary node anatomy and physiology may enhance the cosmetic results of breast cancer conservative surgery, either owing to less breast edema or to a better tolerance to the effects of surgery and radiotherapy. Our aim was to compare the cosmetic outcome of two randomized groups of patients, on a subjective and objective basis. A consecutive series of breast cancer patients (n = 60) submitted to partial mastectomy plus axillary dissection or partial mastectomy plus SN biopsy (included in a randomized trial) was photographed. Photos were analysed in three ways: by seven different observers according to seven features from poor to excellent; two observers estimated the percentage of breast retraction assessment (pBRA); or by the BCCT.core 1.0(®) software. The panel subjective analysis showed a benefit in terms of the skin colour for the patients submitted to SN biopsy only. This group of patients did not show any advantage in terms of pBRA estimates even after the complex BCCT.core appraisal. The sentinel node concept is not associated with improvements in the aesthetic outcome of breast cancer conservative treatment.