Selective axillary dissection after axillary reverse mapping to prevent breast-cancer-related lymphoedema

Gennaro, Massimiliano; Maccauro, Marco; Sigari, Carmela; Casalini, Patrizia; Bedodi, L.; Conti, A.; Caraceni, Augusto; Bombardieri, Emilio

doi:10.1016/j.ejso.2013.09.022

Cited by 40 publications

(48 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The identification rate for arm-draining lymph nodes obtained in the present study (88.8 %) indicates that the ARM technique was effective in the great majority of patients and is in the upper range of rates reported in the literature (61.0–90.3 %) for ARM with patent blue dye8–18,20 (Table 3). Gennaro et al22 injected an isotope on the back of the ipsilateral hand and were able to identify arm-draining lymph nodes in 45 of 60 patients (75 %). In a pilot study reported in 2009, Noguchi23 described a new technique in which they used a fluorescence imaging system with the injection of indocyanine green and were able to identify arm-draining lymph nodes in seven of eight patients.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prospective Study Evaluating Oncological Safety of Axillary Reverse Mapping

Schünemann

Dória

Silvestre³

et al. 2014

Ann Surg Oncol

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

“…However, very few studies have evaluated this outcome 15,22,26. Using ARM, Tausch et al26 were able to preserve one or more upper-limb lymph nodes in 71/143 cases.…”

Section: Discussionmentioning

confidence: 99%

Prospective Study Evaluating Oncological Safety of Axillary Reverse Mapping

Schünemann

Dória

Silvestre³

et al. 2014

Ann Surg Oncol

View full text Add to dashboard Cite

show abstract

“…Consequently, the ARM nodes were identified in 21 (91%) of 23 patients during ALND (Table 1). Although Gennaro et al 23 used only radioisotope for identifying ARM nodes, it does not enable the lymphatic vessels to be visualized as well as blue dye. In the ARM procedure, it is important to visualize ARM lymphatics because the purpose of ARM procedure is to preserve the lymphatic pathway from the upper extremity.…”

Section: Identification Of Arm Nodesmentioning

confidence: 98%

“…In several studies, lymphedema was evaluated by volumetric measurement 25,34 or arm circumference measurement of both arms. 12,19,23,30 Gennaro et al 23 performed arm circumference measurement of both arms. In their study, 45 patients underwent selective ALND where ARM nodes were preserved, and 15 patients received standard ALND with removal of the ARM nodes.…”

Section: Prevention Of Arm Edemamentioning

confidence: 99%