Is axillary reverse mapping feasible in breast cancer patients?

Noguchi, Masakuni; Miura, Seiko; Morioka, Emi; Ohno, Yukako; Yokoi-Noguchi, Miki; Nakano, Yukiko; Kosaka, Takeo

doi:10.1016/j.ejso.2015.01.029

Cited by 26 publications

(25 citation statements)

References 49 publications

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“…Noguchi et al injected ICG sub‐dermally in the wrist and triceps, and visualized axillary lymph nodes by means of a fluorescence imaging camera. This was later validated in a larger study wherein ARM nodes were detected in 85% of patients . Of note, at least two other centers have reported using ICG for ARM …”

Section: Introductionmentioning

confidence: 72%

“…The preference of many surgeons to use dual agents in the breast, ISB and TSC, for the mapping of sentinel nodes, incentivized the search for a third contrast agent that is selectively taken up by lymphatics. ICG‐based infrared imaging has been shown to visualize arm‐draining lymphatics and nodes in breast cancer and to map sentinel nodes in melanoma too …”

Section: Discussionmentioning

confidence: 99%

“…ARM has been primarily performed using ISB while mapping of SLNs is done with TSC . This approach assures that blue ARM nodes are identified and not indiscriminantly removed in the course of sentinel node resection.…”

Section: Introductionmentioning

confidence: 99%

“…Commonly, in the United States, SLN biopsy is performed with peri‐areolar or peritumoral TSC and ISB injections . Dual‐mapping is preferred by many surgeons as it has been associated with higher SLN identification rates . Indocyanine green (IC‐Green™, ICG) has been reported as an alternative agent for lymphatic mapping.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Axillary reverse mapping with indocyanine green or isosulfan blue demonstrate similar crossover rates to radiotracer identified sentinel nodes

Foster

Choy

Porter

et al. 2017

Journal of Surgical Oncology

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Section: Introductionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Axillary reverse mapping with indocyanine green or isosulfan blue demonstrate similar crossover rates to radiotracer identified sentinel nodes

Foster

Choy

Porter

et al. 2017

Journal of Surgical Oncology

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“…With respect to the pathologic status of resected ARM nodes, the overall metastatic rate was 16.9%. This may be explained by that the ARM nodes were located in the central nodal group for breast lymphatic drainage, which was also supported by the existence of converged SLN-ARM nodes [ 43 ]. Additionally, the numerous interconnections shared by lymphatic drainages of the arm and the breast may contribute to ARM metastasis [ 20 ].…”

Section: Discussionmentioning

confidence: 97%

The Feasibility and Oncological Safety of Axillary Reverse Mapping in Patients with Breast Cancer: A Systematic Review and Meta-Analysis of Prospective Studies

et al. 2016

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ObjectiveThe axillary reverse mapping (ARM) technique has recently been developed to prevent lymphedema by preserving the arm lymphatic drainage during sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND) procedures. The objective of this systematic review and meta-analysis was to evaluate the feasibility and oncological safety of ARM.MethodsWe searched Medline, Embase, Web of science, Scopus, and the Cochrane Library for relevant prospective studies. The identification rate of ARM nodes, the crossover rate of SLN-ARM nodes, the proportion of metastatic ARM nodes, and the incidence of complications were pooled into meta-analyses by the random-effects model.ResultsA total of 24 prospective studies were included into meta-analyses, of which 11 studies reported ARM during SLNB, and 18 studies reported ARM during SLNB. The overall identification rate of ARM nodes was 38.2% (95% CI 32.9%-43.8%) during SLNB and 82.8% (78.0%-86.6%) during ALND, respectively. The crossover rate of SLN-ARM nodes was 19.6% (95% CI 14.4%-26.1%). The metastatic rate of ARM nodes was 16.9% (95% CI 14.2%-20.1%). The pooled incidence of lymphedema was 4.1% (95% CI 2.9–5.9%) for patients undergoing ARM procedure.ConclusionsThe ARM procedure was feasible during ALND. Nevertheless, it was restricted by low identification rate of ARM nodes during SLNB. ARM was beneficial for preventing lymphedema. However, this technique should be performed with caution given the possibility of crossover SLN-ARM nodes and metastatic ARM nodes. ARM appeared to be unsuitable for patients with clinically positive breast cancer due to oncological safety concern.

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Comparison of indocyanine green and methylene blue use for axillary reverse mapping during axillary lymph node dissection

Wang

Zeng

et al. 2020

MedComm

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Axillary reverse mapping (ARM) is a technique to identify arm lymphatic drainage during axillary lymph node dissection (ALND). This study compared the feasibility of ARM using indocyanine green (ICG) or methylene blue (MB), and accessed the oncologic safety of the procedure. Overall, 158 patients qualified for ALND were enrolled. The characteristics of ARM‐identified nodes were recorded with ICG (n = 78) or MB (n = 80) visualization. Fine‐needle aspiration cytology (FNAC) of the nodes were performed and validated by histologic analysis. The nodal identification rate in the ICG group significantly surpassed that of the MB group (87.2% vs 52.5%, P < .05) with fewer complications. Note that 10.9% of the patients had metastatic involvement of the ARM‐identified nodes. Also 80% of the positive nodes were found in areas B and D, while the ARM‐identified nodes mainly located in area A. All the 51 nodes diagnosed as negative of malignancy by FNAC were free of metastasis. Nodal metastasis was significantly correlated with extensive nodel involvement, advanced disease, and the characteristics of identified nodes. In conclusion, ICG appears superior to MB for ARM nodes identification. FNAC, together with the features of primary tumors and ARM nodes, can delineate which nodes could be preserved during ALND.

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Is axillary reverse mapping feasible in breast cancer patients?

Cited by 26 publications

References 49 publications

Axillary reverse mapping with indocyanine green or isosulfan blue demonstrate similar crossover rates to radiotracer identified sentinel nodes

Axillary reverse mapping with indocyanine green or isosulfan blue demonstrate similar crossover rates to radiotracer identified sentinel nodes

The Feasibility and Oncological Safety of Axillary Reverse Mapping in Patients with Breast Cancer: A Systematic Review and Meta-Analysis of Prospective Studies

Comparison of indocyanine green and methylene blue use for axillary reverse mapping during axillary lymph node dissection

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