Less extensive axillary surgery in node-positive breast cancer preserves patients' arm function
Breast cancer is the most common form of cancer among women, with around 9,600 new cases diagnosed each year in Sweden. The breast cancer can spread to other parts of the body, and the first spread is usually to the lymph nodes that run from the breast to the armpit on the same side. Knowing whether the cancer has spread to these lymph nodes is crucial, as it helps determine the most appropriate treatment.
To properly investigate the lymph node status, some nodes need to be removed. This is done at the same time as the removal of the breast tumour. There are various types of surgery that can be performed in the armpit, and the extent of the operation affects the likelihood of arm-related side effects afterwards.
In a newly published thesis from Karolinska Institutet, PhD student Matilda Appelgren at the Department of Medical Epidemiology and Biostatistics, evaluated how different surgical methods for axillary staging affect arm morbidity and health-related quality of life (HRQoL) one year after surgery for node-positive breast cancer. The work also explored patients’ experiences of living with the consequences of breast-cancer related axillary surgery. Her thesis aimed to deepen the understanding of how various types of surgical methods for axillary staging affect patient-reported arm morbidity and HRQoL, as well as their impact on everyday life.
What are the most important results in your thesis?
“The main finding of my thesis is that less extensive axillary surgery in patients with node-positive breast cancer helps preserve arm function. HRQoL, however, does not appear to be correlated with the severity of arm morbidity. As, highlighted in the interview study, arm symptoms are described years after surgery, albeit to varying extents. Patients experiencing more severe arm impairment seem to face difficulties to receive adequate support and their daily life may be negative affected.“
Why did you become interested in this topic?
“In my clinical role as a specialist nurse in breast cancer, questions about postoperative arm problems and how they might affect daily life are frequently raised. I believe that gaining a deeper understanding of the consequences of axillary staging surgery could improve pre-and postoperative counselling and help address patients’ concerns and expectations more effectively.“
What do you think should be done in future research?
“Further research is needed to understand how arm symptoms may develop long-term, especially since women in the interview study who experienced more severe arm impairment also described a negative impact on their everyday lives.
The knowledge about arm-related problems and their impact on daily life presented in this thesis can be used to provide personalised patient information and enable more tailored follow-up for arm symptoms that may occur after axillary surgery for node-positive breast cancer.”