Prospective study evaluating oncological safety of axillary reverse mapping.

Area of Science:

• Oncology
• Surgical Innovation
• Lymphedema Research

Background:

• Axillary reverse mapping (ARM) aims to reduce lymphedema after breast cancer surgery.
• The oncological safety of preserving lymphatic drainage via ARM is not well-established.

Purpose of the Study:

• To evaluate the presence of metastases in ARM nodes.
• To assess the oncological risk associated with the ARM technique.

Main Methods:

• 45 patients undergoing ARM during axillary lymph node dissection (ALND).
• Blue dye used for ARM node localization.
• Separate pathological evaluation of all removed lymph nodes, including ARM nodes.

Main Results:

• ARM nodes successfully identified in 88.9% of patients.
• Metastases detected in 25% of ARM nodes (10/40 patients).
• Extensive axillary cancer significantly increased the risk of ARM node metastasis (p < 0.001).

Conclusions:

• The significant rate of metastasis in ARM nodes raises concerns about the technique's viability.
• Further research is needed to identify patient subgroups for whom ARM may be safely employed.