Journal of the American College of Surgeons
Volume 206, Issue 5 , Pages 1038-1042 , May 2008

Axillary Reverse Mapping: Mapping and Preserving Arm Lymphatics May Be Important in Preventing Lymphedema During Sentinel Lymph Node Biopsy

Presented at the Southern Surgical Association 119th Annual Meeting, Hot Springs, VA, December 2007.

  • Cristiano Boneti, MD

      Affiliations

    • Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences and the Winthrop P Rockefeller Cancer Institute, Little Rock, AR
    • Drs Boneti and Klimberg are supported by the Fashion Footwear Association of New York
    • ,
  • Soheila Korourian, MD

      Affiliations

    • Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences and the Winthrop P Rockefeller Cancer Institute, Little Rock, AR
    • Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR.
    • ,
  • Keiva Bland, MD

      Affiliations

    • Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences and the Winthrop P Rockefeller Cancer Institute, Little Rock, AR
    • Drs Bland, Cox, and Klimberg are supported by the Susan G Komen Breast Cancer Clinical Fellowship and the Arkansas Breast Cancer Act.
    • ,
  • Kristin Cox, MD

      Affiliations

    • Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences and the Winthrop P Rockefeller Cancer Institute, Little Rock, AR
    • Drs Bland, Cox, and Klimberg are supported by the Susan G Komen Breast Cancer Clinical Fellowship and the Arkansas Breast Cancer Act.
    • ,
  • Laura L. Adkins, MS

      Affiliations

    • Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences and the Winthrop P Rockefeller Cancer Institute, Little Rock, AR
    • ,
  • Ronda S. Henry-Tillman, MD, FACS

      Affiliations

    • Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences and the Winthrop P Rockefeller Cancer Institute, Little Rock, AR
    • ,
  • V. Suzanne Klimberg, MD, FACS

      Affiliations

    • Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences and the Winthrop P Rockefeller Cancer Institute, Little Rock, AR
    • Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR.
    • Corresponding Author InformationCorrespondence address: V Suzanne Klimberg, MD, 4301 West Markham, Slot 725, Little Rock, AR 72205-7199.
    • Drs Boneti and Klimberg are supported by the Fashion Footwear Association of New York
    • Drs Bland, Cox, and Klimberg are supported by the Susan G Komen Breast Cancer Clinical Fellowship and the Arkansas Breast Cancer Act.

Received 12 December 2007 ,Accepted 13 December 2007.

References 

  1. Thompson M, Korourian S, Henry-Tillman R, et al. Axillary reverse mapping (ARM): A new concept to identify and enhance lymphatic preservation. Ann Surg Oncol. 2007;14:1890–1895
  2. Klimberg VS. A new concept toward the prevention of lymphedema: Axillary reverse mapping. J Surg Oncol. 2007;Oct 22; [Epub ahead of print]
  3. Schrenk P, Rieger R, Shamiyeh A, et al. Morbidity following sentinel lymph node biopsy versus axillary lymph node dissection for patients with breast carcinoma. Cancer. 2000;88:608–614
  4. Haid A, Koberle-Wuhrer R, Knauer M, et al. Morbidity of breast cancer patients following complete axillary dissection or sentinel node biopsy only: a comparative evaluation. Breast Cancer Res Treat. 2002;73:31–36
  5. Swenson KK, Nissen MJ, Ceronsky C, et al. Comparison of side effects between sentinel lymph node and axillary lymph node dissection for breast cancer. Ann Surg Oncol. 2002;9:745–753
  6. Blanchard DK, Donohue JH, Reynolds C, et al. Relapse and morbidity in patients undergoing sentinel lymph node biopsy alone or with axillary dissection for breast cancer. Arch Surg. 2003;138:482–488
  7. Schijven MP, Vingerhoets AJ, Rutten HJ, et al. Comparison of morbidity between axillary lymph node dissection and sentinel node biopsy. Eur J Surg Oncol. 2003;29:341–350
  8. Ronka R, von Smitten K, Tasmuth T, Leidenius M. One-year morbidity after sentinel node biopsy and breast surgery. Breast. 2005;14:28–36
  9. Leidenius M, Leivonen M, Vironen J, von Smitten K. The consequences of long-time arm morbidity in node-negative breast cancer patients with sentinel node biopsy or axillary clearance. J Surg Oncol. 2005;92:23–31
  10. Mansel R, Fallowfield L, Kissin M, et al. Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: The ALMANAC Trial. JNCI. 2006;98:599–609
  11. Wilke LG, McCall LM, Posther KE, et al. Surgical complications associated with sentinel lymph node biopsy: results from a prospective international cooperative group trial. Ann Surg Oncol. 2006;13:491–500
  12. Sakorafas GH, Peros G, Cataliotti L, et al. Lymphedema following axillary lymph node dissection for breast cancer. Surg Oncol. 2006;15:153–165
  13. Layeeque R, Kepple J, Henry-Tillman RS, et al. Intraoperative subareolar radioisotope injection for immediate sentinel lymph node biopsy. Ann Surg. 2004;239:841–845discussion, 845–848
  14. Henry-Tillman RS, Korourian S, Rubio IT, et al. Intraoperative touch preparation for sentinel lymph node biopsy: a 4-year experience. Ann Surg Oncol. 2002;9:333–339
  15. Krag D, Weaver D, Ashikaga T, et al. The sentinel node in breast cancer–a multicenter validation study. N Engl J Med. 1998;339:941–966
  16. Nos C, Lesieur B, Clough KB, Lecuru F. Blue dye injection in the arm in order to conserve the lymphatic drainage of the arm in breast cancer patients requiring an axillary dissection. Ann Surg Oncol. 2007;14:2490–2496

 Competing Interests Declared: Dr Klimberg is a consultant for Ethicon Endo-Surgery.The study is also funded by the Tenenbaum Breast Cancer Research Fund.

PII: S1072-7515(07)01983-7

doi: 10.1016/j.jamcollsurg.2007.12.022

Journal of the American College of Surgeons
Volume 206, Issue 5 , Pages 1038-1042 , May 2008

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