Axillary dissection in primary breast cancer: variations of the surgical technique and influence on morbidity

Figures & data

Table 1 Group comparison (mean ± standard deviation, range, or rate)

	Group 1 (cutting and coagulation) (n = 17)	Group 2 (clamping and ligation) (n = 17)
Age (years)	59.4 ± 12.4 (45–84)	60.3 ± 12.1 (39–83)
BMI (kg/m²)	25.0 ± 2.0 (21–40)	28.2 ± 5.2 (19–39)
Blood pressure preoperative (systolic/diastolic, mmHg)	129 ± 14/76 ± 11 (100–170/55–95)	127 ± 16/75 ± 11 (80–155/60–100)
BCT (%, n)	64.7% (11/17)	64.7% (11/17)
Total duration of surgery (min)	117 ± 36	127 ± 54
pT1 (%, n)	35.3% (6/17)	52.9% (9/17)
pT2 (%, n)	58.8% (10/17)	41.2% (7/17)
pT3/pT4 (%, n)	5.9% (1/17)	5.9% (1/17)
CT (%, n)	76.5% (13/17)	76.5% (13/17)
RT if BCT (%, n)	100% (11/11)	100% (11/11)
PMRT (%, n)	33.3% (2/6)	33.3% (2/6)
ET if HR+ (%, n)	100% (13/13)	100% (14/14)

Note: Differences between group 1 and group 2 are statistically not significant.

Abbreviations: BCT, breast-conserving therapy; CT, chemotherapy; ET, endocrine therapy; HR+, hormone responsive; PMRT, postmastectomy radiation therapy; pT, pathologic tumor stage; RT, radiation therapy.

Figure 1 Comparison of the amount of drained fluid drained from the axilla between group 1 (surgery based on cutting and coagulation) and group 2 (surgery based on clamping and ligatures).

Note: The difference between the groups was not statistically significant.

Table 2 Comparison of the outcome variables between group 1 and group 2 (mean ± standard deviation, range, or rate)

	Group 1 (cutting and coagulation) (n = 17)	Group 2 (clamping and ligation) (n = 17)
Total number of resected lymph nodes (n)	11.1 ± 6.4	13.6 ± 5.7
Number of resected lymph nodes level I (n)	6.8 ± 4.5	9.8 ± 4.1
Number of resected lymph nodes level II (n)	3.4 ± 2.5	3.0 ± 2.8
Number of resected lymph nodes level III (n)	0.9 ± 1.7	0.8 ± 1.0
Primary outcome variables
Total amount of drained fluid (mL)	803 ± 546 (160–1480)	712 ± 382 (110–2270)
Duration of suction drain (days)	10.1 ± 4.0 (5–14)	9.5 ± 3.9 (4–19)
Immediate seroma after removal of suction drain (%)	23.5	11.8
Secondary outcome variables
Lymphedema after 3 months (%, n)	41.2 (7/17)	29.4 (5/17)
Lymphedema after 6 months (%, n)	47.1 (8/17)	47.1 (8/17)
Other morbidity concerning the axillary region after 3 and 6 months (%, n)	0 (0/17)	0 (0/17)
Additional data
Total protein content of drained fluid (g/L)	41.3 ± 7.3 (25–52)	43.2 ± 8.1 (30–59)
Hemoglobin content of drained fluid (g/dL)	2.4 ± 1.3 (0.3–4.6)	2.7 ± 1.8 (0.5–6.1)

Note: Differences between group 1 and group 2 are statistically not significant.

Figure 2 Positive correlation between the number of resected LNs and the total amount of fluid drained from the axilla (P = 0.006; A) and a positive correlation between the number of resected LNs and the duration of the drain (P = 0.015; B).

Abbreviation: LNs, lymph nodes.

Figure 3 Positive correlation between the number of resected LNs and the protein concentration in the drained fluid (P = 0.054; A) and a positive correlation between the number of resected LNs and hemoglobin in the drained fluid (P = 0.045; B).

Abbreviation: LNs, lymph nodes.