Feasibility of Axillary Reverse Mapping (ARM) in cancer breast with positive axilla using sodium diethyl ammonium hydroxide (patent blue) dye

Abstract

Background: Sentinel lymph node biopsy is now a standard therapeutic approach for early-stage breast cancer. Arm lymphatic mapping, according to some researchers, is useful for identifying and preserving the arm lymphatics, and this novel process is referred to as "axillary reverse mapping" (ARM), since the arm lymphatics are being identified for preservation rather than eradication. Aim of the work:To study the feasibility of using sodium diethyl ammonium hydroxide (patent blue) dye to perform an axillary reverse mapping (ARM) procedure in breast cancer women with positive axillary lymph nodes. Patients and methods: This study included (40) patients. All patients were underwent surgery in general surgery and surgical oncology departments of Al-Azhar university hospitals. Inclusion criteria in study, patients who are histopathologically proved to have breast cancer, and patients with clinical and radiological positive axillary lymph nodes. Results: Our study findings; 20.0% were diabetic and 15.5% were hypertensive. 72.5% of studied group managed by MRM and 27.5% by CBS. Majority were below axillary vein 62.5% and lateral to thoracodorsal nerve 57.5% and we had 5 cases not detected regard stain. No case had anaphylaxis, 4 cases had infection, and 2 cases with ulceration and overall complicated cases were 6 (15.0%). Complicated cases significantly elder and higher regard weight and BMI also significantly associated with diabetes mellitus (DM). Conclusion: ARM can be done by using Sodium diethyl ammonium hydroxide (patent blue )dye With high rate of success and very low rate of complications .