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Annals of Oncology Advance Access originally published online on May 25, 2009
Annals of Oncology 2009 20(8):1352-1361; doi:10.1093/annonc/mdp016
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© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

breast cancer

A multicenter cohort study to compare quality of life in breast cancer patients according to sentinel lymph node biopsy or axillary lymph node dissection

T. S. Dabakuyo1,4,*, J. Fraisse2, S. Causeret2, S. Gouy2, M.-M. Padeano2,7, C. Loustalot2, J. Cuisenier2, J.-M. Sauzedde3, M. Smail5, J.-P. Combier6, P. Chevillote6, C. Rosburger6, S. Boulet2, P. Arveux1,4 and F. Bonnetain1,4

1 Biostatistics and Epidemiology Unit, Medical Information Department, Centre Georges François Leclerc, Dijon
2 Department of surgery, Centre Georges François Leclerc, Dijon
3 Val de Saone private general hospital, Mâcon
4 EA 4184, Faculty of Medicine, University of Burgundy, Dijon
5 Sainte Marie private hospital, Chalon Sur Saône
6 Hotel-Dieu hospital, Le Creusot
7 Chenôve private hospital, Chenôve, France

* Correspondence to: Dr T. S. Dabakuyo, Centre Georges-François Leclerc, 1 rue Professeur Marion, 21000 Dijon, France. Tel: +33-03-80-73-75-00 (ext. 3654); Fax: +33-03-80-73-77-65; E-mail: sdabakuyo{at}dijon.fnclcc.fr

Background: This prospective multicenter study assessed and compared the impact of different surgical procedures on quality of life (QoL) in breast cancer patients.

Patients and methods: The EORTC QLQ-C30 and the EORTC QLQ-BR-23 questionnaires were used to assess global health status (GHS), arm (BRAS) and breast (BRBS) symptom scales, before surgery, just after surgery and 6 and 12 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: Before surgery, GHS (P = 0.7807) and BRAS (P = 0.7688) QoL scores were similar whatever the surgical procedure: sentinel node biopsy (SLNB), axillary node dissection (ALND) or SLNB + ALND. As compared with other surgical groups, GHS 75.91 [standard deviation (SD) = 17.44, P = 0.041] and BRAS 11.39 (SD = 15.36, P < 0.0001) were better in the SLNB group 12 months after surgery. Whatever the type of surgery, GHS decreased after surgery (P < 0.0001), but increased 6 months later (P = 0.0016). BRAS symptoms increased just after surgery (P = 0.0329) and until 6 months (P < 0.0001) before decreasing (P < 0.0001).

Conclusions: SLNB improved GHS and BRAS QoL in breast cancer patients. However, surgeons must be cautious, SLNB with ALND results in a poorer QoL.

Key words: breast cancer, quality of life, sentinel lymph node biopsy

Received for publication October 6, 2008. Revision received January 5, 2009. Accepted for publication January 7, 2009.


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