Safety of axillary reverse lymphatic mapping after neoadjuvant chemotherapy for breast cancer:A follow-up study / 中国实用外科杂志

ABSTRACT

OBJECTIVE: To explore the feasibility and safety of axillary reverse lymphatic mapping(ARM) afterneoadjuvant chemotherapy(NAC) for breast cancer.METHODS: The clinical data of 45 breast cancer patients whomreached yc N0 after being treated with NAC in the First Affiliated Hospital of Bengbu Medical College between January 2015 and July 2018 were analyzed retrospectively. Double tracer SLNB,directly ALND,or ALND followed by SLNBfailure/SLN + were performed according to the indication of the disease. All the patients were performed ARM usingmethylene blue dye during operation. The success rate of ARM mapping,tumor invasion rate and the safety of ARMlymph node retention were analyzed statistically.RESULTS: There were 13 patients in the ARM lymph node retentiongroup and 32 patients in the ARM lymph node resection group. Follow-up was up to June 2019,the median follow-uptime was 37.5(12-48)months. Discovery rate of ARM in ALND and SLNB group was 93.1%(27/29) and 40%(8/20)respectively. ARM lymph node and SLN overlap was 3 cases. ARM lymph node tumor metastasis was 1 case. Incidencerate of upper limb edema after surgery was lower in ARM reserved group than excision group(P=0.010). The differencesof local recurrence rate between ARM reserved group and excision group was not significant(P=1.000).CONCLUSION: For breast cancer patients with yc N0 after neoadjuvant therapy,reverse axillary lymph node mapping has a high successrate and a low tumor metastasis rate,which is safe and feasible.