Feasibility of Axillary Reverse Mapping During Sentinel Lymph Node Biopsy in Breast Cancer Patients

Casabona, Federico; Bogliolo, Stefano; Menada, Mario Valenzano; Sala, Paolo; Villa, Giuseppe; Ferrero, Simone

doi:10.1245/s10434-009-0554-x

Cited by 74 publications

(101 citation statements)

References 23 publications

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“…21 Also, similar to our results Casabona F et al, documented that the mean age in his study was 57 years with range 25-81 years, and most of them, 82% (59/72), were post-menopausal compared to 69.44% (50/72) post-menopausal patients in our study (50/72) Beek MA et al, documented in his review for many ARM studies that the visualization rate for axillary nodes and axillary lymphatics in ALND range between (39-90%) and (47-86%) respectively. 24,26 Gebruers N et al, in systemic review for lymphatic visualization mentioned that in ALND the average of detection ratio was 80.8% with range 46.6-94.9% documenting that the coloring technique (Blue dye, isotope, fluorescence) seems that it doesn't have any influence on the detection rate of ARM nodes. 27 This agree with our results where we had successful visualization of lymphatics in 86.1% of cases in the study group after injection of 2.5 ml of methylen blue.…”

Section: Discussionmentioning

confidence: 99%

“…was 16 with range (9-24) nodes. 26 Tummel E et al, mentioned that the median number for excised L.Ns. were 13.3 nodes in patients underwent ALND whether it was accompanied by SLNB or not.…”

Section: Discussionmentioning

confidence: 99%

“…28 Many authors agree with our results that ARM facilitates the preservation of lymphatics draining the arm and decreases the postoperative lymphedema rate. [20][21][22][23][24][25][26][27][28] Ikeda K et al, concluded that Information regarding the ARM factors could predict the incidence of arm lymphedema in patients with breast cancer following post axillary surgery and documented that ARM node positivity is a positive risk factors for lymphedema. 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.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

“…was 16 with range (9-24) nodes. 26 Tummel E et al, mentioned that the median number for excised L.Ns. were 13.3 nodes in patients underwent ALND whether it was accompanied by SLNB or not.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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“…5) (Boneti et al, 2008;Casabona et al, 2008Casabona et al, , 2009Nos et al, 2007;Ponzone et al, 2008;Thompson et al, 2007). Thompson et al (2007) injected 2.5 mL of blue dye intradermally or subdermally into the upper inner arm along the medial intramuscular groove of the ipsilateral arm.…”

Section: Mapping By Blue Dye Injectionmentioning

confidence: 99%

Axillary Reverse Mapping in Breast Cancer

Noguchi¹,

Yokoi²,

Nakano³

et al. 2011

Radioisotopes - Applications in Bio-Medical Science

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“…Since 2000, many clinical trials have confirmed that sentinel lymph node biopsy (SLNB) is an accurate technique that permits omitting a complete axillary lymph node dissection (ALND) in selected patients while diminishing the incidence of arm and shoulder morbidity [1,2]. SLNB is developing in new directions (multifocal/multicentric tumors) [3]: applications with neoadjuvant chemotherapy [4][5][6][7][8][9][10], axillary reverse node mapping [11][12][13], and nanotechnology [14]. Axillary lymph node status is the single most significant predictive factor for patients with invasive breast tumors [15].…”

Section: Background and Objectivementioning

confidence: 99%

Ultrasound-guided fine needle aspiration cytology in staging clinically node-negative invasive breast cancer

et al. 2011

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The aim of this study was to evaluate the value of ultrasound (US)-guided axillary lymph node fine needle aspiration cytology (FNAC) in staging clinically nodenegative invasive breast cancer. Based on retrospective data, we analyzed sensitivity, specificity, and positive and negative predictive value and efficacy of preoperative axillary US-guided FNAC. A total of 108 consecutive female patients with histological-confirmed invasive breast cancer between January 2006 and December 2010 were included. The management decisions were based on cytological results. Twenty-two patients underwent neoadjuvant chemotherapy and 86 remaining patients benefited of primary surgery. Patients with positive cytology or included in neoadjuvant regimens were scheduled for axillary lymph node dissection (ALND), while patient with negative or nondiagnostic cytology underwent sentinel lymph node biopsy. Axillary US-guided FNAC was compared with definitive pathology of surgically removed lymph nodes. Axillary metastases were found in 55 out of 108 patients (50.9%). In these cases we proceeded with ALND. Excluding the group benefiting from neoadjuvant chemotherapy, we could spare a second surgical intervention for 37 out of 86 patients (43%). The axillary US with FNAC has a sensitivity of 73%, a specificity of 85%, a positive predictive value of 89%, and a negative predictive value of 66%. Without taking into account the neoadjuvant chemotherapy group, in which the statistical analyzes might be biased by the complete histological response, specificity and positive predictive value increased to 100% and negative predictive value to 71%. US combined with FNAC of axillary lymph nodes is a simple, minimally invasive, and reproducible diagnostic approach in improving the preoperative axillary staging of invasive breast cancer patients.Keywords Invasive breast cancer . Axillary node ultrasound . Axillary node cytology . Sentinel lymph node Background and objective

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Feasibility of Axillary Reverse Mapping During Sentinel Lymph Node Biopsy in Breast Cancer Patients

Abstract: Arm lymphatic drainage can be observed in the SLNB field in 37.5% of the cases. Using the ARM during SLNB may facilitate the preservation of lymphatics draining the arm.

Cited by 74 publications

References 23 publications

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

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

Axillary Reverse Mapping in Breast Cancer

Ultrasound-guided fine needle aspiration cytology in staging clinically node-negative invasive breast cancer

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