"Use of Axillary Reverse Mapping to Prevent Lymphedema During Breast Cancer Treatment: A Systematic Review"

Area of Science:

• Oncology
• Surgical Oncology
• Radiology

Background:

• Lymphedema affects up to 65% of breast cancer patients, influenced by diagnostic methods and treatment.
• Preventive strategies for lymphedema are crucial in breast cancer care.
• Axillary reverse mapping (ARM) is a technique to identify lymphatics draining the arm.

Purpose of the Study:

• To systematically review the literature on the use of axillary reverse mapping to prevent lymphedema in breast cancer patients.
• To evaluate the hypothesis that identifying arm-draining lymph nodes can reduce lymphedema incidence.

Main Methods:

• Systematic literature review of PubMed, Cochrane Clinical Answers, and Cochrane Central Register of Controlled Trials.
• Included studies focused on ARM for lymphedema prevention during breast cancer treatment.
• Excluded studies on lymphoscintigraphy for lymphedema diagnosis or treatment evaluation.

Main Results:

• Five studies with 501 patients met eligibility criteria.
• ARM utilized radiography or SPECT/CT, applied with axillary lymph node dissection or radiotherapy.
• ARM identified non-compromised lymph nodes, had prognostic value, and identified high-risk patients when combined with sentinel lymph node biopsy.
• One study showed significant benefits of ARM over standard care in reducing lymphedema incidence.

Conclusions:

• Axillary reverse mapping is a feasible technique for preventing lymphedema in breast cancer patients.
• ARM provides valuable information for treatment planning and risk stratification.
• Further comparative studies of ARM versus standard care are necessary to confirm its efficacy.