Boneti, C., Badgwell, B., Robertson, Y., Korourian, S., Adkins, L., & Klimberg, V. (2012). Axillary reverse mapping (ARM): Initial results of phase II trial in preventing lymphedema after lymphadenectomy. Minerva Ginecologica, 64, 421–430.
To evaluate lymphedema rates when axillary reverse mapping (ARM) is added to lymphadenectomy
After sentinel lymph node localization, ARM was performed by injecting blue dye subcutaneously to localize lymphatics draining the arm. Standard level I and II lymph node dissection was done to include blue lymph nodes as appropriate. Otherwise, blue nodes were preserved. Average follow-up was 14.6 ± 9.4 months.
This was a single-site study conducted in Arkansas.
Patients were undergoing the active antitumor treatment phase of care.
This was an bservational, descriptive study.
Arm volume was measured; the method of measurement was not described.
Almost a third (30%) of patients had axillary staging done prior to neoadjuvant chemotherapy; the remaining patients had the ARM procedure done during their definitive surgical treatment. Overall incidence of lymphedema when the ARM node was preserved was 2.9% compared to 18.7% in patients who had ARM lymphatics resected.
Findings suggest that ARM with preservation of lymph nodes when possible can result in lower incidence of lymphedema.
Findings suggest that the addition of ARM to standard surgical procedures might enable preservation of some lymph nodes with resulting lowered prevalence of lymphedema in patients with breast cancer. This study provides minimal support because of study design and limitations. Long-term effects of lymph node preservation need to be explored.