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Use of Sentinel Lymph Node Biopsy and Early Physiotherapy to Reduce Incidence of Lymphedema After Breast Cancer Surgery: an Institutional Experience

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Abstract

Newer advances in breast cancer management have led to increased disease free survival and overall survival. It is important to prevent debilitating complications after axillary lymph node dissection (ALND) to be able to successfully translate this survival benefit to quality of life benefit. By reducing disruption of lymphatic channels, sentinel lymph node biopsy (SLNB) decreases incidence of lymphedema (LE). Initiating early physiotherapy regimens, too, improves arm symptoms. In this review, we analyze the incidence of LE at our center and compare it with western literature. Retrospective analysis of all post-surgery breast cancer 18 patients, who followed up routinely with our oncophysiotherapist, was carried out. Incidence of LE in patients undergoing SLNB or ALND was followed up for a mean period of 17.5 months. Only 3.6%, i.e., 6 patients out of 166 developed LE. Amongst 166, 80 had only SLNB; the rest had ALND (either upfront or post-positive SLNB). None of the SLNB only cohort patients developed LE. SLNB in clinically node negative axilla, followed by initiation of arm physiotherapy early in post-operative period, may reduce LE incidence in breast cancer patients.

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Abbreviations

LE:

Lymphedema

ALND:

Axillary lymph node dissection

SLNB:

Sentinel lymph node biopsy

SLNB F/B ALND:

Sentinel lymph node biopsy followed by axillary lymph node dissection

QoL:

Quality of life

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Acknowledgments

We would like to acknowledge the data extraction efforts of our research analyst, Ms. Shakti Srivastav.

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Correspondence to Sandhya Gupta.

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Gupta, S., Gupta, N., Kadayaprath, G. et al. Use of Sentinel Lymph Node Biopsy and Early Physiotherapy to Reduce Incidence of Lymphedema After Breast Cancer Surgery: an Institutional Experience. Indian J Surg Oncol 11, 15–18 (2020). https://doi.org/10.1007/s13193-019-01030-4

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