Axillary reverse mapping by dye method in 300 breast cancer patients / 中国肿瘤临床

ABSTRACT

Objective:To assess the ability of axillary reverse mapping (ARM) to identify and preserve the arm lymphatics drainage as well as determine its ability to reduce lymphedema. Methods:A total of 300 breast cancer patients who underwent axillary lymph node dissection (ALND) from June 2009 to May 2011 were enrolled in this study. Methylene blue dye (2 mL to 3 mL) was injected into the ipsilateral upper inner arm along the medial intramuscular groove to map the upper extremity lymphatic drainage system prior to ALND. The blue lymphatic and lymph nodes were identified and preserved during the operation. The change in the arm circumference was the selected method of measurement. The difference in the bilateral upper arm circumference was recorded after 2 months (difference≥2 cm is defined as lymphedema). Results:The ARM was performed successfully in 195 (65%) of 300 patients. The incidence of lymphedema was significantly lower in the successfully mapped patients than in the failing mapping patients, with statistically significant difference during follow-up at 6, 12, 18, and 24 months post operation. Conclusion:The ARM technique can identify and preserve the arm lymphatics drainage and prevent upper extremity lymphedema after breast cancer axillary lymphadenectomy.