Scientific Impact Award: Axillary reverse mapping (ARM) to identify and protect lymphatics draining the arm during axillary lymphadenectomy
Identifieur interne : 006794 ( Main/Exploration ); précédent : 006793; suivant : 006795Scientific Impact Award: Axillary reverse mapping (ARM) to identify and protect lymphatics draining the arm during axillary lymphadenectomy
Auteurs : Cristiano Boneti [États-Unis] ; Soheila Korourian [États-Unis] ; Zuleika Diaz [États-Unis] ; Carlos Santiago [États-Unis] ; Sheila Mumford [États-Unis] ; Laura Adkins [États-Unis] ; V. Suzanne Klimberg [États-Unis]Source :
- The American journal of surgery [ 0002-9610 ] ; 2009.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Cartographie, Drainage, Médecine, Chirurgie.
English descriptors
- KwdEn :
Abstract
INTRODUCTION: The axillary reverse mapping (ARM) procedure distinguishes lymphatics draining the arm from those draining the breast. The aim of this study was to assess the ability of ARM to identify and preserve lymphatics draining the arm and the impact on lymphedema. METHODS: This study included 220 patients undergoing sentinel lymph node (SLN) biopsy (SLNB) with or without axillary lymph node dissection (ALND) from May 2006 to September 2008. After SLN localization with a radioactive tracer, blue dye was used to map ARM lymphatics. Data were collected on identification and variations in lymphatic drainage, crossover rate, the incidence of metastases, and nodal status. RESULTS: Crossover (ARM = SLN) occurred in 6 patients (2.8%). ARM lymphatics were near or in the SLN field in 40.6% of patients, placing it at risk for disruption during lymphadenectomy. ARM lymphatics juxtaposed to the hot SLNB (n = 12 [5.6%]) were preserved. Fifteen ARM nodes were excised and were negative even in positive axillae. There were no cases of lymphedema at 6-month follow-up where ARM nodes were preserved. CONCLUSION: Confluence of the arm and breast drainage is rarely the SLN, and none of these nodes contained metastases. Preserving the ARM nodes may translate into a lower incidence of postoperative lymphedema.
Affiliations:
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Rockefeller Cancer Institute</s1><s2>Little Rock, AR</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Arkansas</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Department of Pathology, University of Arkansas for Medical Sciences</s1><s2>Little Rock, AR</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Arkansas</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">09-0436859</idno><date when="2009">2009</date><idno type="stanalyst">PASCAL 09-0436859 INIST</idno><idno type="RBID">Pascal:09-0436859</idno><idno type="wicri:Area/PascalFrancis/Corpus">000299</idno><idno type="wicri:Area/PascalFrancis/Curation">000659</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000306</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000306</idno><idno type="wicri:doubleKey">0002-9610:2009:Boneti C:scientific:impact:award</idno><idno type="wicri:Area/Main/Merge">006876</idno><idno type="wicri:Area/Main/Curation">006794</idno><idno type="wicri:Area/Main/Exploration">006794</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Scientific Impact Award: Axillary reverse mapping (ARM) to identify and protect lymphatics draining the arm during axillary lymphadenectomy</title><author><name sortKey="Boneti, Cristiano" sort="Boneti, Cristiano" uniqKey="Boneti C" first="Cristiano" last="Boneti">Cristiano Boneti</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences and the Winthrop P. Rockefeller Cancer Institute</s1><s2>Little Rock, AR</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Arkansas</region></placeName></affiliation></author><author><name sortKey="Korourian, Soheila" sort="Korourian, Soheila" uniqKey="Korourian S" first="Soheila" last="Korourian">Soheila Korourian</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Department of Pathology, University of Arkansas for Medical Sciences</s1><s2>Little Rock, AR</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Arkansas</region></placeName></affiliation></author><author><name sortKey="Diaz, Zuleika" sort="Diaz, Zuleika" uniqKey="Diaz Z" first="Zuleika" last="Diaz">Zuleika Diaz</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences and the Winthrop P. Rockefeller Cancer Institute</s1><s2>Little Rock, AR</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Arkansas</region></placeName></affiliation></author><author><name sortKey="Santiago, Carlos" sort="Santiago, Carlos" uniqKey="Santiago C" first="Carlos" last="Santiago">Carlos Santiago</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences and the Winthrop P. Rockefeller Cancer Institute</s1><s2>Little Rock, AR</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Arkansas</region></placeName></affiliation></author><author><name sortKey="Mumford, Sheila" sort="Mumford, Sheila" uniqKey="Mumford S" first="Sheila" last="Mumford">Sheila Mumford</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences and the Winthrop P. Rockefeller Cancer Institute</s1><s2>Little Rock, AR</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Arkansas</region></placeName></affiliation></author><author><name sortKey="Adkins, Laura" sort="Adkins, Laura" uniqKey="Adkins L" first="Laura" last="Adkins">Laura Adkins</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences and the Winthrop P. Rockefeller Cancer Institute</s1><s2>Little Rock, AR</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Arkansas</region></placeName></affiliation></author><author><name sortKey="Suzanne Klimberg, V" sort="Suzanne Klimberg, V" uniqKey="Suzanne Klimberg V" first="V." last="Suzanne Klimberg">V. Suzanne Klimberg</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Division of Breast Surgical Oncology, Department of Surgery, University of Arkansas for Medical Sciences and the Winthrop P. Rockefeller Cancer Institute</s1><s2>Little Rock, AR</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Arkansas</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Department of Pathology, University of Arkansas for Medical Sciences</s1><s2>Little Rock, AR</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Arkansas</region></placeName></affiliation></author></analytic><series><title level="j" type="main">The American journal of surgery</title><title level="j" type="abbreviated">Am. j. surg.</title><idno type="ISSN">0002-9610</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">The American journal of surgery</title><title level="j" type="abbreviated">Am. j. surg.</title><idno type="ISSN">0002-9610</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Arm</term><term>Axilla</term><term>Axillary</term><term>Breast</term><term>Bypass</term><term>Cartography</term><term>Drainage</term><term>Lymph node</term><term>Lymphadenectomy</term><term>Lymphatic</term><term>Lymphatic system</term><term>Lymphedema</term><term>Mammary gland</term><term>Medicine</term><term>Protection</term><term>Reversibility</term><term>Surgery</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Cartographie</term><term>Axillaire</term><term>Réversibilité</term><term>Lymphoedème</term><term>Bras</term><term>Protection</term><term>Système lymphatique</term><term>Lymphatique</term><term>Ganglion lymphatique</term><term>Lymphadénectomie</term><term>Creux axillaire</term><term>Drainage</term><term>Dérivation</term><term>Sein</term><term>Glande mammaire</term><term>Médecine</term><term>Chirurgie</term><term>Traitement</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Cartographie</term><term>Drainage</term><term>Médecine</term><term>Chirurgie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">INTRODUCTION: The axillary reverse mapping (ARM) procedure distinguishes lymphatics draining the arm from those draining the breast. The aim of this study was to assess the ability of ARM to identify and preserve lymphatics draining the arm and the impact on lymphedema. METHODS: This study included 220 patients undergoing sentinel lymph node (SLN) biopsy (SLNB) with or without axillary lymph node dissection (ALND) from May 2006 to September 2008. After SLN localization with a radioactive tracer, blue dye was used to map ARM lymphatics. Data were collected on identification and variations in lymphatic drainage, crossover rate, the incidence of metastases, and nodal status. RESULTS: Crossover (ARM = SLN) occurred in 6 patients (2.8%). ARM lymphatics were near or in the SLN field in 40.6% of patients, placing it at risk for disruption during lymphadenectomy. ARM lymphatics juxtaposed to the hot SLNB (n = 12 [5.6%]) were preserved. Fifteen ARM nodes were excised and were negative even in positive axillae. There were no cases of lymphedema at 6-month follow-up where ARM nodes were preserved. CONCLUSION: Confluence of the arm and breast drainage is rarely the SLN, and none of these nodes contained metastases. Preserving the ARM nodes may translate into a lower incidence of postoperative lymphedema.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Arkansas</li></region></list><tree><country name="États-Unis"><region name="Arkansas"><name sortKey="Boneti, Cristiano" sort="Boneti, Cristiano" uniqKey="Boneti C" first="Cristiano" last="Boneti">Cristiano Boneti</name></region><name sortKey="Adkins, Laura" sort="Adkins, Laura" uniqKey="Adkins L" first="Laura" last="Adkins">Laura Adkins</name><name sortKey="Diaz, Zuleika" sort="Diaz, Zuleika" uniqKey="Diaz Z" first="Zuleika" last="Diaz">Zuleika Diaz</name><name sortKey="Korourian, Soheila" sort="Korourian, Soheila" uniqKey="Korourian S" first="Soheila" last="Korourian">Soheila Korourian</name><name sortKey="Mumford, Sheila" sort="Mumford, Sheila" uniqKey="Mumford S" first="Sheila" last="Mumford">Sheila Mumford</name><name sortKey="Santiago, Carlos" sort="Santiago, Carlos" uniqKey="Santiago C" first="Carlos" last="Santiago">Carlos Santiago</name><name sortKey="Suzanne Klimberg, V" sort="Suzanne Klimberg, V" uniqKey="Suzanne Klimberg V" first="V." last="Suzanne Klimberg">V. Suzanne Klimberg</name><name sortKey="Suzanne Klimberg, V" sort="Suzanne Klimberg, V" uniqKey="Suzanne Klimberg V" first="V." last="Suzanne Klimberg">V. Suzanne Klimberg</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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