Axillary reverse mapping in breast cancer: An overview.

Area of Science:

• Oncology
• Surgical Oncology
• Lymphedema Research

Background:

• Breast cancer surgery has evolved from extensive procedures to minimally invasive techniques.
• Axillary dissection, while historically standard, poses a risk of arm lymphedema.
• Sentinel lymph node (SLN) biopsy is now standard for axillary staging, with dissection sometimes deferred.

Purpose of the Study:

• To introduce and explain the technique of axillary reverse mapping (ARM).
• To highlight ARM's potential in preventing upper limb lymphedema post-axillary surgery.
• To differentiate ARM from sentinel biopsy in terms of lymphatic mapping goals.

Main Methods:

• Axillary reverse mapping involves identifying and preserving the lymphatic drainage of the upper limb.
• The technique is applied during axillary dissection or sentinel lymph node biopsy procedures.
• It is based on the principle that breast and arm lymphatic pathways are distinct.

Main Results:

• ARM aims to conserve the arm's lymphatic system, thereby preventing or reducing lymphedema.
• Preserving upper limb lymphatic drainage does not appear to increase the risk of axillary recurrence.
• This contrasts with sentinel biopsy, which focuses on removing breast-draining lymph nodes.

Conclusions:

• Axillary reverse mapping is a promising technique to mitigate lymphedema after breast cancer surgery.
• ARM offers a method to preserve arm function and quality of life for patients.
• The technique supports a shift towards more conservative surgical approaches in breast cancer management.