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Related Experiment Video

Updated: Jul 11, 2025

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
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Axillary Reverse Mapping in Clinically Node-Positive Breast Cancer Patients.

Masakuni Noguchi1, Masafumi Inokuchi1, Miki Yokoi-Noguchi1

  • 1Breast Center, Department of Breast and Endocrine Surgery, Kanazawa Medical University Hospital, Daigaku-1-1, Uchinada, Kahoku 920-0293, Ishikawa, Japan.

Cancers
|November 14, 2023
PubMed
Summary
This summary is machine-generated.

Neoadjuvant chemotherapy (NAC) significantly reduces axillary reverse mapping (ARM) node metastasis in clinically node-positive breast cancer patients. However, 18F-FDG-PET/CT imaging is not reliable for detecting residual axillary disease post-NAC.

Keywords:
axillary lymph node dissectionaxillary reverse mappingbreast cancerneoadjuvant chemotherapy

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Nuclear Medicine

Background:

  • Axillary reverse mapping (ARM) nodes are frequently involved in clinically node-positive (cN+) breast cancer.
  • Neoadjuvant chemotherapy (NAC) effectively reduces nodal metastases in cN+ patients.

Purpose of the Study:

  • To evaluate the impact of NAC on ARM node involvement in cN+ breast cancer patients.
  • To assess the utility of 18F-FDG-PET/CT in detecting residual axillary disease after NAC.

Main Methods:

  • 145 cN+ patients with confirmed nodal involvement underwent either upfront axillary lymph node dissection (ALND) or ALND after NAC.
  • Patients underwent 18F-FDG-PET/CT before surgery and an ARM procedure during ALND.

Main Results:

  • ARM node involvement was significantly lower in the NAC group (36.6%) compared to the upfront surgery group (62.2%).
  • NAC decreased involvement in non-luminal tumors (18.4%) more than luminal tumors (48.5%).
  • 18F-FDG-PET/CT findings did not reliably predict residual ARM node involvement post-NAC.

Conclusions:

  • NAC significantly reduces the risk of ARM node metastasis in cN+ breast cancer.
  • 18F-FDG-PET/CT is not suitable for detecting residual metastatic disease in the axilla after NAC.