Axillary reverse mapping using fluorescence imaging is useful for identifying the risk group of postoperative lymphedema in breast cancer patients undergoing sentinel node biopsies.
Bottom Line: In contrast, none of the patients in the noncorresponding group developed lymphedema.ARM during SN biopsy can identify the group of patients who are at high risk for developing lymphedema.More risk-focused guidance should be used for these patients.
Affiliation: Division of Surgery, Saitama Social Insurance Hospital, Saitama, Japan.Show MeSH
Related in: MedlinePlus
Mentions: Between August 2009 and July 2012, 432 SNB procedures for breast cancer were performed at our hospital. Among these, 372 patients who underwent surgery for Stage 0–IIB (Tis–T3, N0, and M0) primary breast cancer, without preoperative chemotherapy or bilateral disease, were enrolled in this study. Forty-five patients who revealed sentinel lymph node (SN) metastasis (pN1 mi and pN1) were excluded. Finally 327 patients were studied and they were divided into 2 groups (corresponding and noncorresponding groups). We defined the corresponding group as those with upper extremity lymphatic drainage into the breast SN (ICG fluorescence “shine” at the breast SN and/or upper extremity blue lymphatic drainage into the breast SN) and the noncorresponding group as those with both “do not shine” and “do not drain from the upper extremity.” Six of the 327 patients were unsuitable for analysis because of recurrence or loss to follow-up; thus, 321 patients who had undergone the SNB procedure were finally analyzed (Fig. 1). This study was approved by the institutional review board of our hospital, and all patients agreed to participate after providing written informed consent.
Affiliation: Division of Surgery, Saitama Social Insurance Hospital, Saitama, Japan.