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Extensive nodal involvement increases the positivity of blue nodes in the axillary reverse mapping procedure in patients with breast cancer
Author(s) -
Rubio Isabel T.,
Cebrecos Isaac,
Peg Vicente,
Esgueva Antonio,
Mendoza Cesar,
Cortadellas Tomas,
Cordoba Octavi,
EspinosaBravo Martin,
Xercavins Jordi
Publication year - 2012
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23048
Subject(s) - medicine , axilla , breast cancer , lymphedema , prospective cohort study , surgery , sentinel node , lymph node , axillary lymph node dissection , sentinel lymph node , radiology , cancer
Background The axillary reverse mapping (ARM) technique has been proposed to prevent arm lymphedema. We conducted this study to assess the feasibility of the technique and the outcomes of patients with neoadjuvant chemotherapy (NAC). Methods From July 2009 to May 2010, a prospective study was performed in 36 patients with breast cancer undergoing an ALND. The ARM technique was performed injecting 3 cm 3 of Patent Blue in the ipsilateral arm. Of the 36 patients, 29 patients received NAC previously to the ARM and 7 patients had an ALND and ARM performed as first treatment for positive axillary nodes. Results The identification rate of blue nodes was 83.3% (30 patients). Sentinel lymph node (SLN) was performed in 15 of 29 (42%) patients in the NAC group. Of these 15, two patients (13%) had a concordance between the blue and the hot node. Blue nodes were positive in 4 (13%) of the 30 patients. Conclusions The ARM technique is feasible in patients undergoing NAC. Patients with extensive nodal involvement have increased risk of having positive blue nodes. More studies are needed to assess the subgroup of patients with positive axilla that may have the blue node spared without compromising the oncological treatment. J. Surg. Oncol. 2012; 106:89–93. © 2012 Wiley Periodicals, Inc.