CA breast morbidity and mortality associated with level 2 and level 3 lymph node dissections

Abstract

Introduction:In India, the prevalence of breast cancer is growing increasingly becoming the number one cancer in women who are moving cervical cancer to second place. The aim of the study was evaluation of associated factors and prognosis of Ca breast morbidity and mortality associated with level 2 and level 3 lymph node dissections. Material and methods: This prospective study was conducted at Jubilee Mission Medical College and Research Institute Thrissur,by the department of general surgery. All the breast carcinoma patients were included in this study who were diagnosed between 2007 June to 2009 January After dissection of lymph nodes at stage I-II, the shoulder was then flexed so that the pectoral muscles could relax. Pectoralis minor wasraised forward or drawn with a retractor on the lateralfoot. Lymph node level III was identified as the nodes between the medial boundaries of the lymph. The minor muscle pectoralis and the subclavius tendon were cleared. Lymph nodes of Category III have been independently labelled with pathological examination. Results: Total two hundred women to the age group between 20-80 years were included in this study. Among them 86 (43%) were belonged to age group between 40-60 years with median age of 54.6 years. The carcinoma of breast in patients 106 (53%) had right side 91 (45.5%) had left side whereas 3 (1.5%) had bilateral involvement. Evaluation of post-operative sequelae was conducted on all patients at one, three and sixmonths. By clinical review, wound inflammation and seroma were observed and limited arm mobility was clinically graded as mild moderate and severe. Conclusion: This study concludes that carcinoma of breastmorbidity and mortality is associated with level II and level III lymph nodes dissection. Level III clearance with minimum morbidity was observed. It seems like a partial (level I and II) dissection in order to be the most suitable method for both staging and local regulation because it reduces the axillary bulk tissue of the node. The occurrence of morbidities increase with higher levels of axillary clearance is seen in this study.