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See Latest ArticlesExtensive nodal disease may impair axillary reverse mapping in patients with breast cancer
Journal of Clinical Oncology, 10/15/09
Ponzone R et al. – The aim of axillary reverse mapping (ARM) is to preserve arm lymphatics in patients with breast cancer who underwent surgical axillary staging. In the presence of extensive nodal disease, this technique may identify metastatic blue nodes, which demonstrates that there is not reliable separation of arm and breast lymphatic pathways.
Methods- From June 2007 to December 2008, 49 patients who required axillary dissection (AD) underwent ARM
- One milliliter of patent blue dye injected in ipsilateral arm, and all blue nodes identified during AD were sent separately for pathologic examination
- Main variables associated with detection rates of blue lymphatics, the pathologic status of blue and nonblue nodes, and the complications of procedure analyzed
- Identification rates of blue lymphatics and blue nodes were 73.5% and 55.1%, respectively
- Blue node identification influenced by time elapsed between injection of blue dye and surgery but not by learning curve of procedure
- Although blue node was clear of metastases in 24 of 27 patients, 3 patients with extensive nodal metastatic involvement showed breast cancer metastatic cells in blue nodes as well
- Only adverse effect of procedure was skin tattooing at injection site, which disappeared within 4 months in almost 80% of the procedures
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