Axillary Reverse Mapping: Five Year Experience
Identifieur interne : 002D25 ( Main/Exploration ); précédent : 002D24; suivant : 002D26Axillary Reverse Mapping: Five Year Experience
Auteurs : Daniela Ochoa [États-Unis] ; Soheila Korourian [États-Unis] ; Cristiano Boneti [États-Unis] ; Laura Adkins [États-Unis] ; Brian Badgwell ; V. Suzanne Klimberg [États-Unis]Source :
- Surgery [ 0039-6060 ] ; 2014.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Agents colorants, Aisselle (), Aisselle (anatomie et histologie), Biopsie de noeud lymphatique sentinelle (), Biopsie de noeud lymphatique sentinelle (effets indésirables), Femelle, Humains, Lymphoedème (), Lymphoedème (étiologie), Magenta I, Noeuds lymphatiques (), Noeuds lymphatiques (anatomopathologie), Radiopharmaceutiques, Sulfocolloïde de technétium (99mTc), Tumeurs du sein (anatomopathologie), Vaisseaux lymphatiques (anatomie et histologie), Études de suivi.
- MESH :
- anatomie et histologie : Aisselle, Vaisseaux lymphatiques.
- anatomopathologie : Noeuds lymphatiques, Tumeurs du sein.
- effets indésirables : Biopsie de noeud lymphatique sentinelle.
- étiologie : Lymphoedème.
- Adulte d'âge moyen, Agents colorants, Aisselle, Biopsie de noeud lymphatique sentinelle, Femelle, Humains, Lymphoedème, Magenta I, Noeuds lymphatiques, Radiopharmaceutiques, Sulfocolloïde de technétium (99mTc), Études de suivi.
English descriptors
- KwdEn :
- Axilla (anatomy & histology), Axilla (surgery), Breast Neoplasms (pathology), Coloring Agents, Female, Follow-Up Studies, Humans, Lymph Nodes (pathology), Lymph Nodes (surgery), Lymphatic Vessels (anatomy & histology), Lymphedema (etiology), Lymphedema (prevention & control), Middle Aged, Radiopharmaceuticals, Rosaniline Dyes, Sentinel Lymph Node Biopsy (adverse effects), Sentinel Lymph Node Biopsy (methods), Technetium Tc 99m Sulfur Colloid.
- MESH :
- chemical : Coloring Agents, Radiopharmaceuticals, Rosaniline Dyes, Technetium Tc 99m Sulfur Colloid.
- adverse effects : Sentinel Lymph Node Biopsy.
- anatomy & histology : Axilla, Lymphatic Vessels.
- etiology : Lymphedema.
- methods : Sentinel Lymph Node Biopsy.
- pathology : Breast Neoplasms, Lymph Nodes.
- prevention & control : Lymphedema.
- surgery : Axilla, Lymph Nodes.
- Female, Follow-Up Studies, Humans, Middle Aged.
Abstract
We hypothesize that mapping the lymphatic drainage of the arm with blue dye (axillary reverse mapping, ARM) during axillary lymphadenectomy decreases the likelihood of disruption of lymphatics and subsequent lymphedema.
This institutional review board-approved study from May 2006 to October 2011 involved 360 patients undergoing SLNB and/or ALND. Technetium sulfur colloid (4 mL) was injected subareolarly and 5 mL of blue dye was injected subcutaneously in the volar surface ipsilateral upper extremity (ARM). Data were collected on variations in lymphatic drainage, successful identification and protection of arm lymphatics, crossover, and occurrence of lymphedema.
A group of 360 patients underwent SLNB and/or ALND. A total of 348 patients underwent a SLNB. Of those, 237/348(68.1%) had a SLNB only and 111/348(31.9%) went on to an ALND due to a positive axilla. An additional 12/360(3.3%) axilla had ALND due to a clinically positive axilla/preoperative core needle biopsy. In 96%(334/348) of patients with SLNB, breast SLNs were hot but not blue; crossover (SLN hot and blue) was seen in 14/348(4%). Blue lymphatics were identified in 80/237(33.7%) of SLN incisions and in 93/123(75.4%) ALND. Average follow-up was 12 months (range 3 to 48 months) and resulted in a SLNB lymphedema rate of 1.7%(4/237) and ALND of 2.4%(3/123).
ARM identified significant lymphatic variations draining the upper extremities and facilitated preservation. Metastases in ARM-identified lymph nodes were acceptably low indicating that ARM is safe. ARM added to present-day ALND and SLNB may be useful to lower lymphedema rates.
Url:
DOI: 10.1016/j.surg.2014.05.011
PubMed: 25444319
PubMed Central: 4354953
Affiliations:
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Le document en format XML
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Axilla (anatomy & histology)</term>
<term>Axilla (surgery)</term>
<term>Breast Neoplasms (pathology)</term>
<term>Coloring Agents</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Lymph Nodes (pathology)</term>
<term>Lymph Nodes (surgery)</term>
<term>Lymphatic Vessels (anatomy & histology)</term>
<term>Lymphedema (etiology)</term>
<term>Lymphedema (prevention & control)</term>
<term>Middle Aged</term>
<term>Radiopharmaceuticals</term>
<term>Rosaniline Dyes</term>
<term>Sentinel Lymph Node Biopsy (adverse effects)</term>
<term>Sentinel Lymph Node Biopsy (methods)</term>
<term>Technetium Tc 99m Sulfur Colloid</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Agents colorants</term>
<term>Aisselle ()</term>
<term>Aisselle (anatomie et histologie)</term>
<term>Biopsie de noeud lymphatique sentinelle ()</term>
<term>Biopsie de noeud lymphatique sentinelle (effets indésirables)</term>
<term>Femelle</term>
<term>Humains</term>
<term>Lymphoedème ()</term>
<term>Lymphoedème (étiologie)</term>
<term>Magenta I</term>
<term>Noeuds lymphatiques ()</term>
<term>Noeuds lymphatiques (anatomopathologie)</term>
<term>Radiopharmaceutiques</term>
<term>Sulfocolloïde de technétium (99mTc)</term>
<term>Tumeurs du sein (anatomopathologie)</term>
<term>Vaisseaux lymphatiques (anatomie et histologie)</term>
<term>Études de suivi</term>
</keywords>
<keywords scheme="MESH" type="chemical" xml:lang="en"><term>Coloring Agents</term>
<term>Radiopharmaceuticals</term>
<term>Rosaniline Dyes</term>
<term>Technetium Tc 99m Sulfur Colloid</term>
</keywords>
<keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Sentinel Lymph Node Biopsy</term>
</keywords>
<keywords scheme="MESH" qualifier="anatomie et histologie" xml:lang="fr"><term>Aisselle</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>Axilla</term>
<term>Lymphatic Vessels</term>
</keywords>
<keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Biopsie de noeud lymphatique sentinelle</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphedema</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Sentinel Lymph Node Biopsy</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="surgery" xml:lang="en"><term>Axilla</term>
<term>Lymph Nodes</term>
</keywords>
<keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Lymphoedème</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Middle Aged</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Agents colorants</term>
<term>Aisselle</term>
<term>Biopsie de noeud lymphatique sentinelle</term>
<term>Femelle</term>
<term>Humains</term>
<term>Lymphoedème</term>
<term>Magenta I</term>
<term>Noeuds lymphatiques</term>
<term>Radiopharmaceutiques</term>
<term>Sulfocolloïde de technétium (99mTc)</term>
<term>Études de suivi</term>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>BACKGROUND</title>
<p id="P1">We hypothesize that mapping the lymphatic drainage of the arm with blue dye (axillary reverse mapping, ARM) during axillary lymphadenectomy decreases the likelihood of disruption of lymphatics and subsequent lymphedema.</p>
</sec>
<sec id="S2"><title>METHODS</title>
<p id="P2">This institutional review board-approved study from May 2006 to October 2011 involved 360 patients undergoing SLNB and/or ALND. Technetium sulfur colloid (4 mL) was injected subareolarly and 5 mL of blue dye was injected subcutaneously in the volar surface ipsilateral upper extremity (ARM). Data were collected on variations in lymphatic drainage, successful identification and protection of arm lymphatics, crossover, and occurrence of lymphedema.</p>
</sec>
<sec id="S3"><title>RESULTS</title>
<p id="P3">A group of 360 patients underwent SLNB and/or ALND. A total of 348 patients underwent a SLNB. Of those, 237/348(68.1%) had a SLNB only and 111/348(31.9%) went on to an ALND due to a positive axilla. An additional 12/360(3.3%) axilla had ALND due to a clinically positive axilla/preoperative core needle biopsy. In 96%(334/348) of patients with SLNB, breast SLNs were hot but not blue; crossover (SLN hot and blue) was seen in 14/348(4%). Blue lymphatics were identified in 80/237(33.7%) of SLN incisions and in 93/123(75.4%) ALND. Average follow-up was 12 months (range 3 to 48 months) and resulted in a SLNB lymphedema rate of 1.7%(4/237) and ALND of 2.4%(3/123).</p>
</sec>
<sec id="S4"><title>CONCLUSIONS</title>
<p id="P4">ARM identified significant lymphatic variations draining the upper extremities and facilitated preservation. Metastases in ARM-identified lymph nodes were acceptably low indicating that ARM is safe. ARM added to present-day ALND and SLNB may be useful to lower lymphedema rates.</p>
</sec>
</div>
</front>
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<name sortKey="Adkins, Laura" sort="Adkins, Laura" uniqKey="Adkins L" first="Laura" last="Adkins">Laura Adkins</name>
<name sortKey="Boneti, Cristiano" sort="Boneti, Cristiano" uniqKey="Boneti C" first="Cristiano" last="Boneti">Cristiano Boneti</name>
<name sortKey="Klimberg, V Suzanne" sort="Klimberg, V Suzanne" uniqKey="Klimberg V" first="V. Suzanne" last="Klimberg">V. Suzanne Klimberg</name>
<name sortKey="Klimberg, V Suzanne" sort="Klimberg, V Suzanne" uniqKey="Klimberg V" first="V. Suzanne" last="Klimberg">V. Suzanne Klimberg</name>
<name sortKey="Korourian, Soheila" sort="Korourian, Soheila" uniqKey="Korourian S" first="Soheila" last="Korourian">Soheila Korourian</name>
</country>
</tree>
</affiliations>
</record>
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Pour générer des pages wiki
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