The Feasibility and Oncological Safety of Axillary Reverse Mapping in Patients with Breast Cancer: A Systematic Review and Meta-Analysis of Prospective Studies
Identifieur interne : 000A53 ( Main/Exploration ); précédent : 000A52; suivant : 000A54The Feasibility and Oncological Safety of Axillary Reverse Mapping in Patients with Breast Cancer: A Systematic Review and Meta-Analysis of Prospective Studies
Auteurs : Chao Han [République populaire de Chine] ; Ben Yang [République populaire de Chine] ; Wen-Shu Zuo [République populaire de Chine] ; Gang Zheng [République populaire de Chine] ; Li Yang [République populaire de Chine] ; Mei-Zhu Zheng [République populaire de Chine]Source :
- PLoS ONE [ 1932-6203 ] ; 2016.
Descripteurs français
- KwdFr :
- Agents colorants (administration et posologie), Aisselle, Biopsie de noeud lymphatique sentinelle (effets indésirables), Bras (anatomie et histologie), Femelle, Humains, Injections intradermiques, Lymphadénectomie (), Lymphadénectomie (effets indésirables), Lymphoedème (), Lymphoedème (étiologie), Métastase lymphatique, Noeuds lymphatiques (anatomopathologie), Soins préopératoires, Système lymphatique (anatomie et histologie), Tumeurs du sein (anatomopathologie), Vaisseaux lymphatiques (anatomie et histologie), Études de faisabilité, Études prospectives.
- MESH :
- administration et posologie : Agents colorants.
- anatomie et histologie : Bras, Système lymphatique, Vaisseaux lymphatiques.
- anatomopathologie : Noeuds lymphatiques, Tumeurs du sein.
- effets indésirables : Biopsie de noeud lymphatique sentinelle, Lymphadénectomie.
- étiologie : Lymphoedème.
- Aisselle, Femelle, Humains, Injections intradermiques, Lymphadénectomie, Lymphoedème, Métastase lymphatique, Soins préopératoires, Études de faisabilité, Études prospectives.
English descriptors
- KwdEn :
- Arm (anatomy & histology), Axilla, Breast Neoplasms (pathology), Coloring Agents (administration & dosage), Feasibility Studies, Female, Humans, Injections, Intradermal, Lymph Node Excision (adverse effects), Lymph Node Excision (methods), Lymph Nodes (pathology), Lymphatic Metastasis, Lymphatic System (anatomy & histology), Lymphatic Vessels (anatomy & histology), Lymphedema (etiology), Lymphedema (prevention & control), Preoperative Care, Prospective Studies, Sentinel Lymph Node Biopsy (adverse effects).
- MESH :
- chemical , administration & dosage : Coloring Agents.
- adverse effects : Lymph Node Excision, Sentinel Lymph Node Biopsy.
- anatomy & histology : Arm, Lymphatic System, Lymphatic Vessels.
- etiology : Lymphedema.
- methods : Lymph Node Excision.
- pathology : Breast Neoplasms, Lymph Nodes.
- prevention & control : Lymphedema.
- Axilla, Feasibility Studies, Female, Humans, Injections, Intradermal, Lymphatic Metastasis, Preoperative Care, Prospective Studies.
Abstract
The axillary reverse mapping (ARM) technique has recently been developed to prevent lymphedema by preserving the arm lymphatic drainage during sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND) procedures. The objective of this systematic review and meta-analysis was to evaluate the feasibility and oncological safety of ARM.
We searched Medline, Embase, Web of science, Scopus, and the Cochrane Library for relevant prospective studies. The identification rate of ARM nodes, the crossover rate of SLN-ARM nodes, the proportion of metastatic ARM nodes, and the incidence of complications were pooled into meta-analyses by the random-effects model.
A total of 24 prospective studies were included into meta-analyses, of which 11 studies reported ARM during SLNB, and 18 studies reported ARM during SLNB. The overall identification rate of ARM nodes was 38.2% (95% CI 32.9%-43.8%) during SLNB and 82.8% (78.0%-86.6%) during ALND, respectively. The crossover rate of SLN-ARM nodes was 19.6% (95% CI 14.4%-26.1%). The metastatic rate of ARM nodes was 16.9% (95% CI 14.2%-20.1%). The pooled incidence of lymphedema was 4.1% (95% CI 2.9–5.9%) for patients undergoing ARM procedure.
The ARM procedure was feasible during ALND. Nevertheless, it was restricted by low identification rate of ARM nodes during SLNB. ARM was beneficial for preventing lymphedema. However, this technique should be performed with caution given the possibility of crossover SLN-ARM nodes and metastatic ARM nodes. ARM appeared to be unsuitable for patients with clinically positive breast cancer due to oncological safety concern.
Url:
DOI: 10.1371/journal.pone.0150285
PubMed: 26919589
PubMed Central: 4769133
Affiliations:
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Breast Cancer: A Systematic Review and Meta-Analysis of Prospective Studies</title><author><name sortKey="Han, Chao" sort="Han, Chao" uniqKey="Han C" first="Chao" last="Han">Chao Han</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Department of Surgery II, Breast Cancer Center, Shandong Cancer Hospital and Institute, Jinan, Shandong, China</addr-line></nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Surgery II, Breast Cancer Center, Shandong Cancer Hospital and Institute, Jinan, Shandong</wicri:regionArea><wicri:noRegion>Shandong</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>School of Medicine and life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong, China</addr-line></nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>School of Medicine and life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong</wicri:regionArea><wicri:noRegion>Shandong</wicri:noRegion></affiliation></author><author><name sortKey="Yang, Ben" sort="Yang, Ben" uniqKey="Yang B" first="Ben" last="Yang">Ben Yang</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Department of Surgery II, Breast Cancer Center, Shandong Cancer Hospital and Institute, Jinan, Shandong, China</addr-line></nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Surgery II, Breast Cancer Center, Shandong Cancer Hospital and Institute, Jinan, Shandong</wicri:regionArea><wicri:noRegion>Shandong</wicri:noRegion></affiliation></author><author><name sortKey="Zuo, Wen Shu" sort="Zuo, Wen Shu" uniqKey="Zuo W" first="Wen-Shu" last="Zuo">Wen-Shu Zuo</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Department of Surgery II, Breast Cancer Center, Shandong Cancer Hospital and Institute, Jinan, Shandong, China</addr-line></nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Surgery II, Breast Cancer Center, Shandong Cancer Hospital and Institute, Jinan, Shandong</wicri:regionArea><wicri:noRegion>Shandong</wicri:noRegion></affiliation></author><author><name sortKey="Zheng, Gang" sort="Zheng, Gang" uniqKey="Zheng G" first="Gang" last="Zheng">Gang Zheng</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Department of Surgery II, Breast Cancer Center, Shandong Cancer Hospital and Institute, Jinan, Shandong, China</addr-line></nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Surgery II, Breast Cancer Center, Shandong Cancer Hospital and Institute, Jinan, Shandong</wicri:regionArea><wicri:noRegion>Shandong</wicri:noRegion></affiliation></author><author><name sortKey="Yang, Li" sort="Yang, Li" uniqKey="Yang L" first="Li" last="Yang">Li Yang</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Department of Surgery II, Breast Cancer Center, Shandong Cancer Hospital and Institute, Jinan, Shandong, China</addr-line></nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Surgery II, Breast Cancer Center, Shandong Cancer Hospital and Institute, Jinan, Shandong</wicri:regionArea><wicri:noRegion>Shandong</wicri:noRegion></affiliation></author><author><name sortKey="Zheng, Mei Zhu" sort="Zheng, Mei Zhu" uniqKey="Zheng M" first="Mei-Zhu" last="Zheng">Mei-Zhu Zheng</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Department of Surgery II, Breast Cancer Center, Shandong Cancer Hospital and Institute, Jinan, Shandong, China</addr-line></nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Surgery II, Breast Cancer Center, Shandong Cancer Hospital and Institute, Jinan, Shandong</wicri:regionArea><wicri:noRegion>Shandong</wicri:noRegion></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Arm (anatomy & histology)</term><term>Axilla</term><term>Breast Neoplasms (pathology)</term><term>Coloring Agents (administration & dosage)</term><term>Feasibility Studies</term><term>Female</term><term>Humans</term><term>Injections, Intradermal</term><term>Lymph Node Excision (adverse effects)</term><term>Lymph Node Excision (methods)</term><term>Lymph Nodes (pathology)</term><term>Lymphatic Metastasis</term><term>Lymphatic System (anatomy & histology)</term><term>Lymphatic Vessels (anatomy & histology)</term><term>Lymphedema (etiology)</term><term>Lymphedema (prevention & control)</term><term>Preoperative Care</term><term>Prospective Studies</term><term>Sentinel Lymph Node Biopsy (adverse effects)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Agents colorants (administration et posologie)</term><term>Aisselle</term><term>Biopsie de noeud lymphatique sentinelle (effets indésirables)</term><term>Bras (anatomie et histologie)</term><term>Femelle</term><term>Humains</term><term>Injections intradermiques</term><term>Lymphadénectomie ()</term><term>Lymphadénectomie (effets indésirables)</term><term>Lymphoedème ()</term><term>Lymphoedème (étiologie)</term><term>Métastase lymphatique</term><term>Noeuds lymphatiques (anatomopathologie)</term><term>Soins préopératoires</term><term>Système lymphatique (anatomie et histologie)</term><term>Tumeurs du sein (anatomopathologie)</term><term>Vaisseaux lymphatiques (anatomie et histologie)</term><term>Études de faisabilité</term><term>Études prospectives</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Coloring Agents</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Agents colorants</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Lymph Node Excision</term><term>Sentinel Lymph Node Biopsy</term></keywords><keywords scheme="MESH" qualifier="anatomie et histologie" xml:lang="fr"><term>Bras</term><term>Système lymphatique</term><term>Vaisseaux lymphatiques</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Noeuds lymphatiques</term><term>Tumeurs du sein</term></keywords><keywords scheme="MESH" qualifier="anatomy & histology" xml:lang="en"><term>Arm</term><term>Lymphatic System</term><term>Lymphatic Vessels</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Biopsie de noeud lymphatique sentinelle</term><term>Lymphadénectomie</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Lymph Node Excision</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Breast Neoplasms</term><term>Lymph Nodes</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Lymphoedème</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Axilla</term><term>Feasibility Studies</term><term>Female</term><term>Humans</term><term>Injections, Intradermal</term><term>Lymphatic Metastasis</term><term>Preoperative Care</term><term>Prospective Studies</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Aisselle</term><term>Femelle</term><term>Humains</term><term>Injections intradermiques</term><term>Lymphadénectomie</term><term>Lymphoedème</term><term>Métastase lymphatique</term><term>Soins préopératoires</term><term>Études de faisabilité</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Objective</title><p>The axillary reverse mapping (ARM) technique has recently been developed to prevent lymphedema by preserving the arm lymphatic drainage during sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND) procedures. The objective of this systematic review and meta-analysis was to evaluate the feasibility and oncological safety of ARM.</p></sec><sec id="sec002"><title>Methods</title><p>We searched Medline, Embase, Web of science, Scopus, and the Cochrane Library for relevant prospective studies. The identification rate of ARM nodes, the crossover rate of SLN-ARM nodes, the proportion of metastatic ARM nodes, and the incidence of complications were pooled into meta-analyses by the random-effects model.</p></sec><sec id="sec003"><title>Results</title><p>A total of 24 prospective studies were included into meta-analyses, of which 11 studies reported ARM during SLNB, and 18 studies reported ARM during SLNB. The overall identification rate of ARM nodes was 38.2% (95% CI 32.9%-43.8%) during SLNB and 82.8% (78.0%-86.6%) during ALND, respectively. The crossover rate of SLN-ARM nodes was 19.6% (95% CI 14.4%-26.1%). The metastatic rate of ARM nodes was 16.9% (95% CI 14.2%-20.1%). The pooled incidence of lymphedema was 4.1% (95% CI 2.9–5.9%) for patients undergoing ARM procedure.</p></sec><sec id="sec004"><title>Conclusions</title><p>The ARM procedure was feasible during ALND. Nevertheless, it was restricted by low identification rate of ARM nodes during SLNB. ARM was beneficial for preventing lymphedema. However, this technique should be performed with caution given the possibility of crossover SLN-ARM nodes and metastatic ARM nodes. ARM appeared to be unsuitable for patients with clinically positive breast cancer due to oncological safety concern.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Gradishar, Wj" uniqKey="Gradishar W">WJ Gradishar</name></author><author><name sortKey="Anderson, Bo" uniqKey="Anderson B">BO Anderson</name></author><author><name sortKey="Balassanian, R" uniqKey="Balassanian R">R Balassanian</name></author><author><name sortKey="Blair, Sl" uniqKey="Blair S">SL Blair</name></author><author><name sortKey="Burstein, Hj" uniqKey="Burstein H">HJ Burstein</name></author><author><name sortKey="Cyr, A" uniqKey="Cyr A">A Cyr</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Desantis, C" uniqKey="Desantis C">C DeSantis</name></author><author><name sortKey="Ma, J" uniqKey="Ma J">J Ma</name></author><author><name sortKey="Bryan, L" uniqKey="Bryan L">L Bryan</name></author><author><name sortKey="Jemal, A" 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Green</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>République populaire de Chine</li></country></list><tree><country name="République populaire de Chine"><noRegion><name sortKey="Han, Chao" sort="Han, Chao" uniqKey="Han C" first="Chao" last="Han">Chao Han</name></noRegion><name sortKey="Han, Chao" sort="Han, Chao" uniqKey="Han C" first="Chao" last="Han">Chao Han</name><name sortKey="Yang, Ben" sort="Yang, Ben" uniqKey="Yang B" first="Ben" last="Yang">Ben Yang</name><name sortKey="Yang, Li" sort="Yang, Li" uniqKey="Yang L" first="Li" last="Yang">Li Yang</name><name sortKey="Zheng, Gang" sort="Zheng, Gang" uniqKey="Zheng G" first="Gang" last="Zheng">Gang Zheng</name><name sortKey="Zheng, Mei Zhu" sort="Zheng, Mei Zhu" uniqKey="Zheng M" first="Mei-Zhu" last="Zheng">Mei-Zhu Zheng</name><name sortKey="Zuo, Wen Shu" sort="Zuo, Wen Shu" uniqKey="Zuo W" first="Wen-Shu" last="Zuo">Wen-Shu 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