Axillary reverse mapping in breast cancer: A Canadian experience

Abstract

The ARM technique did not prevent identification of the SLN and we identified much greater crossover than reported. We had a single patient, who underwent a sentinel node biopsy, with mild arm lymphedema (1.9%) after 2 years of follow up.

Systematic review of axillary reverse mapping in breast cancer

“…The detailed literature search ( Fig . ) resulted in eight studies being critically appraised within this review.…”

“…The studies were published between 2009 and 2015 ( Tables ). There were seven prospective cohort studies and a single RCT.…”

“…There were technical differences in the performance of the ARM technique. The most authentic ARM technique, which followed the original principle of ‘split mapping’ of the arm and breast simultaneously, was performed by injecting between 1 and 5 ml of blue dye (patent blue, isosulphan blue or methylene blue) either subcutaneously, subdermally or intramuscularly, or by a combination of these, in the ipsilateral upper arm of patients, and injecting radiolabelled nanocolloid subareolarly in the breast. For patients undergoing direct ANC, a modified ARM technique was applied, whereby only lymphatic mapping of the arm was conducted.…”

“…In five studies ARM was assessed at SNB, but between 13 and 86 per cent of patients had completion ANC. ARM lymphatics or nodes were identifiable in between 27 and 100 per cent of patients ( Table ).…”

“…ARM lymphatics or nodes were identifiable in between 27 and 100 per cent of patients ( Table ). ARM crossover nodes were identified in up to 10 per cent of patients undergoing SNB, and metastases were present in up to 20 per cent of these nodes. ARM nodes were excised during ANC in between 11 and 18 per cent of patients, and of those excised the incidence of metastasis ranged between 0 and 19 per cent.…”