Summary

In a prospective study, long term upper-limb morbidity, perceived disabili-ties in activities of daily life (ADL) and quality of life (QOL) were assessed before, at one year and two years after sentinel lymph node biopsy (SLNB) or axillary lymph node dissections (ALND) for breast cancer. Considerable treatment related upper-limb morbidity was observed. Sig-nificant (p<0.05) changes between before and up till two years after surgery were found in almost all assessments of shoulder function, ADL and several QOL subscales. Patients in the ALND group showed significant more changes in range of motion (ROM), grip strength, arm volume, ADL and QOL physi-cal- and role functioning, pain and sleeplessness and arm symptoms com-pared to the SLNB group. Multivariate linear regression analysis showed that radiation therapy on the axilla is besides ALND an important factor in the prediction of impaired shoulder ROM and arm edema