The Efficacy of Axillary Reverse Mapping for the Prevention of Lymphedema.
BACKGROUND: Lymphedema (LE) is the most notable complication of axillary surgery. The axillary reverse mapping (ARM) technique was created to decrease LE. This study aims to evaluate a single surgeon's experience with ARM in patients undergoing sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND) for breast cancer.
METHODS: We retrospectively analyzed patients who underwent SLNB or ALND. Tumor characteristics and treatments received were evaluated. Surgical intervention and use of ARM were compared to assess LE rates. A subgroup analysis was also performed of patients who underwent NAC.
RESULTS: LE was initially reported in 7.1% (n = 10) of patients; 3.3% (n = 4) with SLNB and 35% (n = 6) with ALND. At initial follow-up, LE was reported 16.4% more often in patients who underwent ALND with no ARM, and 38.8% more often in patients who underwent ALND plus ARM. An increased risk of LE was found in patients treated with ALND (OR = 16.0,
DISCUSSION: Our study showed that ARM failed to decrease the incidence of LE. Until better surgical outcomes are shown for the prevention of LE using ARM, other approaches should be utilized. However, larger prospective studies are needed to evaluate ARM.
Published In/Presented At
Ruffino, A. E., Madera, J. D., Dearborn, M. M., Frank, K., & Oxenberg, J. C. (2023). The Efficacy of Axillary Reverse Mapping for the Prevention of Lymphedema. The American surgeon, 31348231198103. Advance online publication. https://doi.org/10.1177/00031348231198103
Medicine and Health Sciences
Hematology-Medical Oncology Division