A randomized controlled research on treating early breast cancer with axillary lymph node group dissec-tion oriented by sentinel lymph nodes instead of axillary dissection / 中华内分泌外科杂志

Objective To research the impact of axillary limph node group dissection oriented by senti-nel lymph nodes instead of axillary dissection on upper limb lymph edema and disease -free survival ( DFS ).Methods We designed a randomized controlled research , which included 205 cases of operatable breast cancer (AJCC 7th:stage I or stage IIa)from Jan.2011 to Jan.2013.Those cases were separated into 2 groups randomly ( random number method ):group A underwent mastectomy ( or lumpectomy ) and axillary group lymphadenectomy oriented by sentinel lymph node biopsy ( SLNB) ( if positive continued for ALND ) while group B underwent mastec-tomy(or lumpectomy)and axillary lymph node dissection(ALND).All patients underwent SLNB by blue dye method and received adjuvant therapy after surgery according to National Comprehensive Cancer Network ( NCCN) guideline and Chinese anti-cancer association guideline .Results There were 101 cases in group A and 104 ca-ses in group B , but 1 case in group A was excluded for false negative of SLN.The midium follow-up was 30 months.There were no significant differences of average age , tumor size, grade, estrogen receptor (ER),proges-terone receptor ( PR) and human epidermal growth factor receptor 2 ( HER2 ) expression between the 2 groups. Group A had a lower frequency of lymph edema than group B (4.0%vs 17.3%,χ2 =9.384,P=0.002), and al-so a milder degree ( mild 2%vs 11.5%,middle 2%vs 3.8%,severe 0%vs 1.9%).There were no significant differences of upper limb sensory disorder (14.0%vs 16.3%,χ2 =0.218,P=0.641), neither of DFS(Log-Rank analysis:3-year average DFS 32.89 months vs 33.72 months,χ2 =0.186,P=0.667;Cox risk model analysis:HR=1.395,P=0.495)between the 2 groups.Conclusion Axillary group lymphadenectomy oriented by SLNB can reduce the happening of lymph edema from ALND and has a comparative effect on DFS as ALND .

Erysipelas of the Upper Extremity Following Surgical Therapy for Breast Cancer

PURPOSE: Erysipelas is a bacterial infection of the dermis and hypodermis, mostly of streptococcal origin, and erysipelas of upper extremity following breast cancer treatment has never been reported in the Korean literature. METHODS: 39-year-old female presented to our hospital complaining of fever and painful swelling of her left upper extremity. She had a history of breast cancer and was treated with breast conserving surgery with axillary lymph node dissection, chemotherapy, and radiation. On physical examination, her left upper extremity showed vesicle, bullae, local heatness and erythema with well-defined margin. With these distinctive features of a skin lesion, we gave a diagnosis of erysipelas and started treatment with intravenous antibiotics. RESULTS: Resolution of the signs and symptoms of erysipelas occurred after 7 days of treatment. CONCLUSION: The diagnosis of erysipelas with distinctive feature of skin lesion is essential and we emphasize that the prevention of any trauma are very important in these patients for prophylactic measures.

Erysipelas of the Upper Extremity Following Surgical Therapy for Breast Cancer

PURPOSE: Erysipelas is a bacterial infection of the dermis and hypodermis, mostly of streptococcal origin, and erysipelas of upper extremity following breast cancer treatment has never been reported in the Korean literature. METHODS: 39-year-old female presented to our hospital complaining of fever and painful swelling of her left upper extremity. She had a history of breast cancer and was treated with breast conserving surgery with axillary lymph node dissection, chemotherapy, and radiation. On physical examination, her left upper extremity showed vesicle, bullae, local heatness and erythema with well-defined margin. With these distinctive features of a skin lesion, we gave a diagnosis of erysipelas and started treatment with intravenous antibiotics. RESULTS: Resolution of the signs and symptoms of erysipelas occurred after 7 days of treatment. CONCLUSION: The diagnosis of erysipelas with distinctive feature of skin lesion is essential and we emphasize that the prevention of any trauma are very important in these patients for prophylactic measures.