{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:26:06Z","timestamp":1789471566800,"version":"build-2803163510"},"reference-count":41,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"25","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2010,9,1]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> Sentinel lymph node resection (SNR) may reduce morbidity while providing the same clinical utility as conventional axillary dissection (AD). National Surgical Adjuvant Breast and Bowel Project (NSABP) B-32 is a randomized phase III trial comparing SNR immediately followed by AD (SNAD) to SNR and subsequent AD if SN is positive. We report the definitive patient-reported outcomes (PRO) comparisons. <\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p> Eligible patients had clinically node-negative, operable invasive breast cancer. The PRO substudy included all SN-negative participants enrolled May 2001 to February 2004 at community institutions in the United States (n = 749; 78% age \u2265 50; 87% clinical tumor size \u2264 2.0 cm; 84% lumpectomy; 87% white). They completed questionnaires presurgery, 1 and 2 to 3 weeks postoperatively, and every 6 months through year 3. Arm symptoms, arm use avoidance, activity limitations, and quality of life (QOL) were compared with intent-to-treat two-sample t-tests and repeated measures analyses. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Arm symptoms were significantly more bothersome for SNAD compared with SNR patients at 6 months (mean, 4.8 v 3.0; P &lt; .001) and at 12 months (3.6 v 2.5; P = .006). Longitudinally, SNAD patients were more likely to experience ipsilateral arm and breast symptoms, restricted work and social activity, and impaired QOL (P \u2264 .002 all items). From 12 to 36 months, fewer than 15% of either SNAD or SNR patients reported moderate or greater severity of any given symptom or activity limitation. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> Arm morbidity was greater with SNAD than with SNR. Despite considerable fears about complications from AD for breast cancer, this study demonstrates that initial problems with either surgery resolve over time. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2010.28.2491","type":"journal-article","created":{"date-parts":[[2010,8,3]],"date-time":"2010-08-03T03:00:31Z","timestamp":1280804431000},"page":"3929-3936","source":"Crossref","is-referenced-by-count":140,"title":["Patient-Reported Outcomes in Sentinel Node\u2013Negative Adjuvant Breast Cancer Patients Receiving Sentinel-Node Biopsy or Axillary Dissection: National Surgical Adjuvant Breast and Bowel Project Phase III Protocol B-32"],"prefix":"10.1200","volume":"28","author":[{"given":"Stephanie R.","family":"Land","sequence":"first","affiliation":[{"name":"From the National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistics Center; Graduate School of Public Health, University of Pittsburgh; Allegheny General Hospital, Pittsburgh, PA; Arthritis Research Center of Canada, University of British Columbia, Vancouver, British Columbia, Canada; University of Vermont College of Medicine; University of Vermont Breast Care Center, United Health Care, Burlington, VT; and the Jonsson Comprehensive Cancer Center, University of California, Los..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacek A.","family":"Kopec","sequence":"additional","affiliation":[{"name":"From the National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistics Center; Graduate School of Public Health, University of Pittsburgh; Allegheny General Hospital, Pittsburgh, PA; Arthritis Research Center of Canada, University of British Columbia, Vancouver, British Columbia, Canada; University of Vermont College of Medicine; University of Vermont Breast Care Center, United Health Care, Burlington, VT; and the Jonsson Comprehensive Cancer Center, University of California, Los..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas B.","family":"Julian","sequence":"additional","affiliation":[{"name":"From the National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistics Center; Graduate School of Public Health, University of Pittsburgh; Allegheny General Hospital, Pittsburgh, PA; Arthritis Research Center of Canada, University of British Columbia, Vancouver, British Columbia, Canada; University of Vermont College of Medicine; University of Vermont Breast Care Center, United Health Care, Burlington, VT; and the Jonsson Comprehensive Cancer Center, University of California, Los..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann M.","family":"Brown","sequence":"additional","affiliation":[{"name":"From the National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistics Center; Graduate School of Public Health, University of Pittsburgh; Allegheny General Hospital, Pittsburgh, PA; Arthritis Research Center of Canada, University of British Columbia, Vancouver, British Columbia, Canada; University of Vermont College of Medicine; University of Vermont Breast Care Center, United Health Care, Burlington, VT; and the Jonsson Comprehensive Cancer Center, University of California, Los..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stewart J.","family":"Anderson","sequence":"additional","affiliation":[{"name":"From the National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistics Center; Graduate School of Public Health, University of Pittsburgh; Allegheny General Hospital, Pittsburgh, PA; Arthritis Research Center of Canada, University of British Columbia, Vancouver, British Columbia, Canada; University of Vermont College of Medicine; University of Vermont Breast Care Center, United Health Care, Burlington, VT; and the Jonsson Comprehensive Cancer Center, University of California, Los..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David N.","family":"Krag","sequence":"additional","affiliation":[{"name":"From the National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistics Center; Graduate School of Public Health, University of Pittsburgh; Allegheny General Hospital, Pittsburgh, PA; Arthritis Research Center of Canada, University of British Columbia, Vancouver, British Columbia, Canada; University of Vermont College of Medicine; University of Vermont Breast Care Center, United Health Care, Burlington, VT; and the Jonsson Comprehensive Cancer Center, University of California, Los..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas J.","family":"Christian","sequence":"additional","affiliation":[{"name":"From the National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistics Center; Graduate School of Public Health, University of Pittsburgh; Allegheny General Hospital, Pittsburgh, PA; Arthritis Research Center of Canada, University of British Columbia, Vancouver, British Columbia, Canada; University of Vermont College of Medicine; University of Vermont Breast Care Center, United Health Care, Burlington, VT; and the Jonsson Comprehensive Cancer Center, University of California, Los..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph P.","family":"Costantino","sequence":"additional","affiliation":[{"name":"From the National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistics Center; Graduate School of Public Health, University of Pittsburgh; Allegheny General Hospital, Pittsburgh, PA; Arthritis Research Center of Canada, University of British Columbia, Vancouver, British Columbia, Canada; University of Vermont College of Medicine; University of Vermont Breast Care Center, United Health Care, Burlington, VT; and the Jonsson Comprehensive Cancer Center, University of California, Los..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norman","family":"Wolmark","sequence":"additional","affiliation":[{"name":"From the National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistics Center; Graduate School of Public Health, University of Pittsburgh; Allegheny General Hospital, Pittsburgh, PA; Arthritis Research Center of Canada, University of British Columbia, Vancouver, British Columbia, Canada; University of Vermont College of Medicine; University of Vermont Breast Care Center, United Health Care, Burlington, VT; and the Jonsson Comprehensive Cancer Center, University of California, Los..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia A.","family":"Ganz","sequence":"additional","affiliation":[{"name":"From the National Surgical Adjuvant Breast and Bowel Project Operations and Biostatistics Center; Graduate School of Public Health, University of Pittsburgh; Allegheny General Hospital, Pittsburgh, PA; Arthritis Research Center of Canada, University of British Columbia, Vancouver, British Columbia, Canada; University of Vermont College of Medicine; University of Vermont Breast Care Center, United Health Care, Burlington, VT; and the Jonsson Comprehensive Cancer Center, University of California, Los..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.08.001"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djj158"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-005-9025-7"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31812e6a73"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-008-0229-z"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1002\/ssu.1037"},{"key":"B7","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1097\/01.sla.0000149429.39656.94","volume":"241","author":"Harlow SP","year":"2005","journal-title":"Ann Surg"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22074"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(07)70278-4"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1007\/BF01806673"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0274(199606)29:6<602::AID-AJIM4>3.0.CO;2-L"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1023\/A:1006214830854"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1497.2006.00384.x"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.05.2597"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1023\/B:BREA.0000032983.87966.4e"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1023\/B:QURE.0000018499.64574.1f"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.2307\/j.ctt1xp3vbc"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1002\/0470846283"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.12.1749"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.2325\/jbcs.14.31"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-007-9593-3"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2007.05.017"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/S1015-9584(09)60052-X"},{"key":"B24","doi-asserted-by":"crossref","first-page":"216S","DOI":"10.1245\/ASO.2004.12.912","volume":"11","author":"Gill PG","year":"2004","journal-title":"Ann Surg Oncol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-008-0202-3"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(06)70947-0"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa012782"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.03.228"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1053\/ejso.2002.1385"},{"key":"B30","first-page":"73","volume":"37","author":"Armer J","year":"2004","journal-title":"Lymphology"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2004.05.006"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2007.08.006"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000245472.47748.ec"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1002\/jso.20406"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2005.11.008"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1245\/ASO.2004.03.512"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-008-9909-y"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-006-9334-z"},{"key":"B39","author":"Ashikaga T","journal-title":"J Surg Oncol"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1046\/j.1445-2197.2002.02309.x"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1185\/030079903125002199"}],"container-title":["Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JCO.2010.28.2491","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T22:24:12Z","timestamp":1653517452000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/JCO.2010.28.2491"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,9,1]]},"references-count":41,"journal-issue":{"issue":"25","published-print":{"date-parts":[[2010,9,1]]}},"alternative-id":["10.1200\/JCO.2010.28.2491"],"URL":"https:\/\/doi.org\/10.1200\/jco.2010.28.2491","relation":{},"ISSN":["0732-183X","1527-7755"],"issn-type":[{"value":"0732-183X","type":"print"},{"value":"1527-7755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,9,1]]}}}