A Longitudinal Comparison of Arm Morbidity in Stage I–II Breast Cancer Patients Treated with Sentinel Lymph Node Biopsy, Sentinel Lymph Node Biopsy Followed by Completion Lymph Node Dissection, or Axillary Lymph Node Dissection

Background:\ud Long-term shoulder and arm function following sentinel lymph node biopsy (SLNB) may surpass that following complete axillary lymph node dissection (CLND) or axillary lymph node dissection (ALND). We objectively examined the morbidity and compared outcomes after SLNB, SLNB + CLND, and ALND in stage I/II breast cancer patients.\ud \ud Materials and Methods:\ud Breast cancer patients who had SLNB (n = 51), SLNB + CLND (n = 55), and ALND (n = 65) were physically examined 1 day before surgery (T0), and after 6 (T1), 26 (T2), 52 (T3), and 104 (T4) weeks. Differences in 8 parameters between the affected and unaffected arms were calculated. General linear models were computed to examine time, group, and interaction effects.\ud \ud Results:\ud All outcomes changed significantly, mostly nonlinearly, over time (T0–T4). Between T1 and T4, limitations decreased in abduction (all groups); anteflexion, abduction-exorotation, abduction strength (SLNB + CLND, ALND); flexion strength (SLNB + CLND); and arm volume (SLNB, SLNB + CLND). At T4, limitations in anteflexion (SLNB, ALND), abduction (SLNB + CLND, ALND), exorotation (ALND), abduction-exorotation (all groups), and volume (SLNB + CLND, ALND) increased significantly compared with T0. The SLNB group showed an advantage in anteflexion, abduction, abduction-exorotation, and volume. Groups changed significantly but differently over time in anteflexion, abduction, abduction/exorotation, abduction strength, flexion strength, and volume. Effect sizes varied from 0.19 to 0.00.\ud \ud Conclusion:\ud Initial declines in range of motion and strength were followed by recovery, although not always to presurgery levels. Range of motion and volume outcomes were better for SLNB than ALND, but not strength. SLNB surpassed SLNB + CLND in 2 of the range of motion variables. The clinical relevance of these results is negligible

Nécrologie du Pr. Michal Cwirko-Godycki

Swedborg I. Nécrologie du Pr. Michal Cwirko-Godycki. In: Bulletins et Mémoires de la Société d'anthropologie de Paris, XIII° Série. Tome 8 fascicule 4, 1981. pp. 385-387

Nécrologie du Pr. Michal Cwirko-Godycki

Swedborg I. Nécrologie du Pr. Michal Cwirko-Godycki. In: Bulletins et Mémoires de la Société d'anthropologie de Paris, XIII° Série. Tome 8 fascicule 4, 1981. pp. 385-387

NEW APPROACHES TO SYMPATHETIC BLOCKS AS TREATMENT OF POSTMASTECTOMY LYMPHEDEMA (REPORT OF A SUCCESSFUL CASE)

The presence of lymphedema following mastectomy still constitutes a serious problem inspite of improved methods of surgery and other forms of cancer therapy. In a recent study about 17% of the patients who had undergone mastectomy combined with radiation therapy the arm volume on the side of the operation was increased to on average 110% or more of that the contralateral side. There was a similar difference in respect of 10% of the patients who had had no radiationtherapy (21). Even slight edema can give rise to pain and annoying sensations of pressure, tension and paresthesia, especially when the edema is located in the hand or at the level of elbow. Edema of the hand in particular is often experienced as a social handicap (20)

IN MEMORIAM

Prof. Prof. h.c. Dr. med. Michael FöldiJanuary 10, 1920 - October 20, 2018“Father of Lymphology