Complications Post-Axillary and Breast Surgery in the Management of Early Breast Cancer

Background: Advanced surgical procedures for axillary staging of early breast cancer are less invasive. Many patients, however, continued to experience side effects such as infections, hematomas, seromas, paresthesia, shoulder stiffness, and arm swelling, which delayed adjuvant therapy and lowered and degraded their overall health.Aim: The research aimed to assess complications and arm morbidity post-axillary and breast surgery when treating early breast cancer.Patient and method: A prospective observational study was carried out on 110 women undergoing sentinel lymph node biopsy, or sentinel lymph node biopsy plus lower axillary sampling, who underwent ductal carcinoma in situ surgery and invasive carcinoma from March 1, 2021, to April 1, 2022, at Smart Health Tower Hospital and Soma General Surgical Hospital in Sulaimani, Iraq. The study tools included a structured interview questionnaire and an observational checklist. It includes seven parts. Socio-demographic features, history of present illness, clinical examination of the breast and axilla, investigations (breast screening), surgical and non-surgical treatments, and surgical technique to obtain a sentinel lymph node biopsy. The following items are on the observational checklist: wound infection, seroma, hematoma, paresthesias, limited upper extremity range of motion, and lymphedema.Results: The complication rates (infections, hematomas, seromas, paresthesia) in patients with sentinel lymph node biopsy plus lower axillary sampling were higher than in patients with sentinel lymph node biopsy alone. A significant association exists between decreased shoulder range of motion and axillary surgery (p = 0.03). ALND and lymphedema have a very strong correlation (p = 0.001).Conclusion: Despite improvement in axillary surgery for axilla staging in early breast cancer, some patients experienced such complications, which delayed adjuvant therapy and decreased their life quality of life.