The influence of axillary reverse mapping related factors on lymphedema in breast cancer patients.

Upper extremity lymphedema (LE) is a harmful breast cancer complication. It has been reported that patient- or treatment-related risk factors of LE. Axillary reverse mapping (ARM) has been performed to prevent LE during axillary lymph node dissection (ALND) by visualizing the upper extremity lymphatics. We investigated whether ARM related factors included novel predictive risk factors of LE. ARM revealed fluorescent axillary nodes (ARM nodes) in 76 patients by fluorescence imaging. Only ARM nodes within the ALND field were removed. Twenty-four (32%) patients developed LE (LE+) and 52 did not (LE-) during a median 24-month post-surgical follow-up period. We retrospectively evaluated the clinical features and ARM factors of LE+ and LE-. The positive ARM node rate among LE+ was 42%, significantly greater frequency than that among LE- (13%: p ≤ 0.05). Cranial collectors (lymphatic ducts along or above the axillary vein) were significantly more frequent in LE- (44%) than in LE+ (21%: p ≤ 0.05). Multivariate analysis revealed postoperative radiation and positive ARM nodes to be positive risk factors and cranial collectors to be a negative risk factor of LE. ARM factors could predict the incidence of LE post-axillary surgeries in breast cancer patients.

Ikeda K ，Ogawa Y ，Kajino C ，Deguchi S ，Kurihara S ，Tashima T ，Goto W ，Nishiguchi Y ，Tokunaga S ，Fukushima H ，Inoue T ... -  《-》

Obesity is a risk factor for developing postoperative lymphedema in breast cancer patients.

Helyer LK ，Varnic M ，Le LW ，Leong W ，McCready D ... -  《-》

Can axillary reverse mapping avoid lymphedema in node positive breast cancer patients?

Tracing lymphatic drainage of the ipsilateral arm of node positive breast cancer patients, termed "axillary reverse mapping" (ARM), has recently been described in several reports. We analyzed our experience with this new technique in patients scheduled for axillary lymph node dissection (ALND) and evaluated its usefulness for reducing the incidence of lymphedema. Blue dye was injected subcutaneously along the intermuscular groove of the upper inner arm; radioisotope was injected subcutaneously in the interdigital webspace of the hand. All blue and radioactive lymph vessels and lymph nodes were recorded. Only unsuspicious "ARM lymph nodes" located in the lateral part of the axillary basin were preserved. All other level I and II axillary lymph nodes were removed. Resected ARM nodes were immediately separated from all other lymph nodes. ARM was performed in 143 patients subsequently undergoing ALND. ARM lymph nodes were successfully identified in 112 cases (78%). In 55 patients at least one ARM lymph node had to be removed. In 14 of these, tumor involvement was confirmed. In 71 patients one or more ARM nodes were preserved. During a median follow-up time of 19 months no axillary recurrence was noted. 35 of 114 evaluated patients developed lymphedema. Preservation of ARM lymph nodes did not significantly decrease the incidence of lymphedema. ARM is feasible for patients with node positive breast cancer. However, we found no evidence that it reduces the incidence of lymphedema.

Tausch C ，Baege A ，Dietrich D ，Vergin I ，Heuer H ，Heusler RH ，Rageth C ... -  《-》

Axillary reverse mapping: mapping and preserving arm lymphatics may be important in preventing lymphedema during sentinel lymph node biopsy.

Boneti C ，Korourian S ，Bland K ，Cox K ，Adkins LL ，Henry-Tillman RS ，Klimberg VS ... -  《-》

Axillary reverse mapping: a prospective study in women with clinically node negative and node positive breast cancer.

Connor C ，McGinness M ，Mammen J ，Ranallo L ，Lafaver S ，Klemp J ，Fan F ，Mahnken J ... -  《-》