Sentinel lymph node biopsy versus complete axillary dissection in breast cancer: Oncological outcomes and lifestyle improvements – An Iraqi perspective

Objectives To evaluate and compare the impact of ALND and SLNB on the oncological outcomes of BC patients. Materials and Methods This is a prospective cohort study that included 160 patients with breast carcinoma who were scheduled to receive total axillary dissection. Patients were randomly assigned to undergo, together with breast surgery, either SLNB and ALND or SLNB followed by ALND only if the SLN was found positive. Follow-up included clinical examination every 4 months for the first 3 years, every 6 months for the following 2 years, and once a year thereafter. A mammography was scheduled annually. Results After 6 months follow-up, eight types of complications were reported. In particular, lymphedema was reported in 4 women (5%) among sentinel LN group and 17 women (21.25%) in complete dissection group, with a highly significant difference. Collectively, 31 women (38.75%) among axillary dissection group had one or more complications compared with 17 women (21.25%) among sentinel LN group who had such complications with a significant difference. In multivariate analysis, each of older age (odds ratio [OR] = 2.62, 95% confidence interval [CI] = 1.24–10.86, P = 0.027), T2 tumor stage (OR = 11.3, 95% CI = 1.06–19.9, P = 0.044), and ALND (OR = 3.2, 95% CI = 1.12–5.31, P = 0.042) were significantly associated with increase the incidence of post-operative complications. Conclusion SLNB is a highly efficient technique for evaluating the stage of the early BC. It is associated with less complication after surgery when compared to ALND. Increased post-operative complications in BC patients, whether handled with SLNB or ALND, are independently linked with advanced age and tumor stage.