Axillary Reverse Mapping in Patients Undergoing Axillary Lymph Node Dissection: A Single Institution Experience From...

Area of Science:

• Oncology
• Surgical Oncology
• Breast Cancer Research

Background:

• Axillary lymph node dissection (ALND) is standard for node-positive breast cancer but causes lymphedema.
• Axillary reverse mapping (ARM) aims to distinguish arm from breast lymphatics to potentially reduce morbidity.
• The utility and oncologic safety of ARM in the Indian population require evaluation.

Purpose of the Study:

• To assess the feasibility of the ARM technique using blue dye in Indian breast cancer patients.
• To determine the incidence of metastases in ARM nodes within this population.
• To correlate ARM identification rates with clinicopathological factors.

Main Methods:

• 120 Indian breast cancer patients undergoing ALND had ARM with blue dye.
• Lymphatic channels and nodes were identified and dissected separately.
• All axillary and ARM nodes were pathologically examined for metastases.

Main Results:

• ARM nodes/lymphatics were identified in 54.17% of patients.
• Patients with higher T and N stages had significantly lower ARM identification rates.
• Metastases were found in 7.5% of identified ARM nodes, exclusively in patients with N2 disease and extensive axillary involvement.

Conclusions:

• Blue dye ARM identification is less effective in Indian patients with advanced clinical T and N stage disease.
• ARM node metastasis is frequent in cases with high axillary tumor burden.
• Preserving ARM nodes may compromise oncologic safety in patients with advanced nodal disease.