Can axillary reverse mapping avoid lymphedema in node positive breast cancer patients?

Tausch, Christoph; Baege, Astrid; Dietrich, Daniel; Vergin, I.; Heuer, Heike; Heusler, R. Haldemann; Rageth, C.

doi:10.1016/j.ejso.2013.05.009

Cited by 47 publications

(54 citation statements)

References 29 publications

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“…These authors achieved an identification rate of 91 %. Tausch et al26 performed ARM in 143 patients: 74 patients were injected with blue dye only; 8 patients were injected with radioactive only; and in 61 patients, a combination of blue dye and radioisotope was injected. The overall identification rate was 78 %: 62 % for blue dye only, 100 % for radioisotope only, and 95 % for the combined technique.…”

Section: Discussionmentioning

confidence: 99%

Prospective Study Evaluating Oncological Safety of Axillary Reverse Mapping

Schünemann

Dória

Silvestre³

et al. 2014

Ann Surg Oncol

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BackgroundAxillary reverse mapping (ARM) is a new technique developed with the aim of reducing lymphedema rates by preserving lymphatic drainage of the upper limbs during sentinel lymph node biopsy and axillary lymph node dissection (ALND). However, it is unclear whether preservation of these lymph nodes affects oncological risk. The present study evaluated the presence of metastases in ARM nodes.MethodsA total of 45 patients underwent ARM during ALND. Blue dye was used for ARM nodes localization. All axillary lymph nodes, including ARM nodes, were removed and sent separately for pathological evaluation of metastases.ResultsARM identification was achieved in 40/45 patients (88.9 %). The average number of removed ARM nodes was 1.9. ARM nodes metastasis occurred in 10 of 40 patients (25 %). Patients with an axilla extensively affected by cancer had an elevated risk of metastasis to the arm’s lymph nodes (p < 0.001).ConclusionsThe rate of arm lymph nodes compromised by metastases calls into question the viability of the ARM technique. Larger studies may point to particular patient profiles for which ARM can be safely use.

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Section: Discussionmentioning

confidence: 99%

Prospective Study Evaluating Oncological Safety of Axillary Reverse Mapping

Schünemann

Dória

Silvestre³

et al. 2014

Ann Surg Oncol

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“…Therefore, combining two tracers may facilitate the detection and visualization of both nodes and lymphatic vessels. Identification rates of ARM nodes using two tracers ranged from 78% to 91%, 22,25 while those with isotope alone ranged from 75% to 100%. 23,24 c. Mapping by fluorescent imaging…”

Section: Identification Of Arm Nodesmentioning

confidence: 98%

“…After a median followup of 16 months, four patients in the former group developed lymphedema (9%) versus five patients in the latter group (33%; p ¼ 0.035). On the other hand, Tausch et al 25 performed volumetric measurement of both arms. Consequently, preservation of ARM nodes did not significantly reduce the incidence of lymphedema following ALND (Table 3).…”

Section: Prevention Of Arm Edemamentioning

confidence: 99%

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Is axillary reverse mapping feasible in breast cancer patients?

Noguchi

Miura

Morioka

et al. 2015

European Journal of Surgical Oncology (EJSO)

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“…29 Contrary to all previous results Tausch C et al, concluded that there is no evidence that ARM decreases the lymphedema rate after ALND in patients with breast cancer. 30 Beek M A et al, told that major problem with the ARM procedure is the assumption that the arm lymphatics plays a minor role in the pathway for breast L.Ns. through the small interconnections present between arm and breast lymphatics.…”

Section: Discussionmentioning

confidence: 99%

Role of axillary reverse mapping in decreasing complications after axillary dissection in breast cancer

et al. 2017

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INTRODUCTIONBreast cancer is the most common malignancy in women worldwide and its incidence increases every year.1 From the total female cancer cases in Egypt, breast cancer represented 35.1%. 2The primary site of lymphatic drainage of the breast is the axillary lymph nodes that involved in regional metastatic disease in breast cancer. Axillary lymph node dissection is the standard treatment of axillary lymph node metastasis. It is important for local control, staging and increase the possibility of survival benefit. 3Most of the serious complications after breast surgery are attributed to axillary lymph node dissection such as; lymphedema, seroma and major neurovascular injuries. 4 Seroma is the most common problem occurring after axillary lymph node dissection; excessive fluid accumulation usually stretches the skin and causes it to sag, resulting in patient discomfort, and delay of adjuvant ABSTRACT Background: Breast cancer is one of the most leading causes of cancer deaths in female. Surgical treatment is considered the corner stone in its management. Axillary lymph node dissection (ALND) is an integral step in most of surgeries done, however it has many morbidities like prolonged seroma and lymphedema. Axillary reverse mapping (ARM) procedure was first described in 2007 in a trial to map the axillary lymphatics of the arm and avoid its injury therefore lymph complications. Methods: A prospective, randomized, controlled study over 72 female patients who underwent modified radical mastectomy (MRM). Patients were divided and randomized into study and control groups, thirty-six patients for each. In study group the ARM procedure was done by injecting 2.5 ml of methylen blue dye intra-dermally and subcutaneously in the upper inner ipsilateral arm along the medial intramuscular groove before ALND. Operative and post-operative results were recorded. Follow up was 6 to 24 months. Results: ARM procedure and successful visualization of arm lymphatics was achieved in 31 patients (86.1%). Statistically there was no significant difference between the two groups regarding patient and tumour characteristics, operative time and number of excised L.Ns. There was significant difference favouring the ARM group in decreasing the incidence of seroma (p= 0.040), lymphedema (p= 0.031) and time passed till remove drains (p <0.001). Conclusions: ARM procedure facilitated arm lymphatics visualization. It is easy non-time-consuming procedure. It resulted in significant reduction in incidence of seroma and lymphedema, with considerable reduction in the overall complications rate.

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Can axillary reverse mapping avoid lymphedema in node positive breast cancer patients?

Cited by 47 publications

References 29 publications

Prospective Study Evaluating Oncological Safety of Axillary Reverse Mapping

Prospective Study Evaluating Oncological Safety of Axillary Reverse Mapping

Is axillary reverse mapping feasible in breast cancer patients?

Role of axillary reverse mapping in decreasing complications after axillary dissection in breast cancer

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