Background: Axillary lymph node dissection (ALND) for staging of the axilla in breast cancer patients may cause considerable
morbidities. Recently, sentinel lymph node biopsy (SLNB) has been shown to accurately define the patients who do not need
ALND. There are multiple possible factors in addition to the extent of axillary surgery that contribute to these morbidities.
Objective: To evaluate arm morbidities in early breast cancer patients who underwent SLNB in comparison with those with
ALND and to identify clinicopathological parameters associated with the development of arm morbidities.
Material and Method: Postoperative morbidities and quality of life were compared in 112 breast cancer patients after ALND
and 85 patients following SLNB at the Division of Head-Neck and Breast Surgery, Siriraj Hospital from October 1997 to
January 2006. Correlations between clinicopathological parameters and arm morbidities were determined by Chi-square
statistics and regression analysis.
Results: Patients’ characteristics were comparable between the two groups. Following ALND, the patients showed significant
increase in arm swelling (9.8%) compared with SLNB (1.2%), as well as a significantly higher rate of numbness. No difference between the two groups was found regarding arm movement, strength, or daily activities. Multivariate analysis showed that ALND is the independent factor that significantly increased arm morbidity.
Conclusion: The authors reported for the first time of post-treatment arm morbidities in Thai breast cancer patients. The
SLNB had been shown to spare the patients’ morbidities resulting from ALND. Therefore, the SLNB should be adopted as an alternative to routine ALND in Thai patients with clinically lymph node negative breast cancer.

Keywords: Breast cancer, Sentinel node biopsy, Axillary dissection, Morbidity