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Axillary reverse mapping using 99mTc-SC: a case illustration.

Sunny J Gandhi¹, C Satish, P Shanmuga Sundaram

¹From the Departments of *Nuclear Medicine & PET CT, and †Surgical Oncology,Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.

Clinical Nuclear Medicine

|October 25, 2013

Summary

Axillary reverse mapping (ARM) identifies arm lymph nodes to prevent breast cancer surgery-related lymphedema. This technique, using Tc-SC, aims to preserve these nodes, reducing lymphedema risk after lymph node biopsy.

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Area of Science:

Oncology
Surgical Oncology
Nuclear Medicine

Background:

Lymphedema frequently complicates breast carcinoma treatment following axillary lymph node dissection.
Sentinel lymph node biopsy reduces lymphedema risk but does not eliminate it.
Axillary reverse mapping (ARM) is an emerging strategy to identify and preserve arm-draining lymph nodes unaffected by cancer.

Observation:

The primary goal of ARM is to prevent lymphedema in breast cancer patients.
ARM nodes can be identified using radiotracers or vital blue dyes.
This study details the procedure for ARM node identification utilizing filtered Technetium-99m-sulfur colloid (Tc-SC).

Findings:

The described procedure successfully identifies axillary reverse mapping nodes.
Filtered Tc-SC is an effective agent for visualizing these specific lymph nodes.
The technique provides a method for surgeons to target lymph nodes crucial for preventing arm swelling.

Implications:

Successful validation of ARM could significantly decrease lymphedema incidence post-breast cancer surgery.
Preserving these specific lymph nodes may become a standard oncologic surgical practice.
This approach offers a promising method to improve quality of life for breast cancer survivors.