Breaking Dogmas in Axillary Lymphadenectomy and Quality of Life
López Gordo, Sandra (Universitat Autònoma de Barcelona. Departament de Ciències Morfològiques)
Jimeno-Fraile, Jaime (Hospital Universitario Marqués de Valdecilla (Santander, Cantabria))
García-Monferrer, Anna (Hospital de Mataró. Consorci Sanitari del Maresme)
Nicolau, Pau (Hospital de Mataró. Consorci Sanitari del Maresme)
Ruiz-Edo, Neus (Hospital de Mataró. Consorci Sanitari del Maresme)
Ramirez-Maldonado, Elena (Hospital Universitari Joan XXIII de Tarragona)
Rojas, Santiago (Universitat Autònoma de Barcelona. Departament de Ciències Morfològiques)
Serra-Serra, Cristina (Hospital de Mataró. Consorci Sanitari del Maresme)

Fecha:	2025
Resumen:	Axillary lymph node dissection (ALND), although increasingly less necessary, is still required in specific breast cancer surgery scenarios, such as cases with a high axillary tumor burden. However, traditional practices are being reassessed due to the associated morbidity and impacts on recovery. This review explores five critical and controversial innovations in ALND: (1) same-day discharge, (2) omission of surgical drains, (3) application of fibrin sealants, (4) minimally invasive techniques, and (5) their collective influence on quality of life (QoL). Same-day discharge has proven to be safe and cost-effective, increasing patient satisfaction without raising complication rates. The omission of drains, while slightly increasing seroma volumes, is linked to shorter hospital stays and fewer complications. The use of fibrin sealants shows promising results in reducing the seroma volume and duration, expediting recovery, although their routine use remains under debate. Minimally invasive and endoscopic techniques reduce morbidity and improve cosmetic outcomes while maintaining oncological safety. Quality of life (QoL) is essential in the evaluation of breast cancer treatment and is evaluated using tools such as EORTC QLQ-C30, QLQ-BR23, and FACT-B, SF-36, which assess physical, emotional, and psychosocial recovery. Innovations in ALND seem to improve QoL by minimizing pain, increasing arm function, and reducing psychological stress, underscoring the importance of patient-centered strategies. Although axillary lymphadenectomy increases arm morbidity compared to sentinel node biopsy, its overall impact on quality of life appears limited, likely due to the overlapping effects of systemic therapies and breast surgery.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article de revisió ; recerca ; Versió publicada
Materia:	Breast cancer ; Axillary lymphadenectomy ; Drain ; Sealant ; Ambulatory ; Minimal invasive surgery ; Quality of life
Publicado en:	Cancers, Vol. 17 Núm. 13 (June 2025) , p. 2201, ISSN 2072-6694

DOI: 10.3390/cancers17132201
PMID: 40647499

22 p, 506.0 KB

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