A Phase I Study to Assess the Feasibility and Oncologic Safety of Axillary Reverse Mapping in Breast Cancer Patients
Identifieur interne : 000247 ( PascalFrancis/Corpus ); précédent : 000246; suivant : 000248A Phase I Study to Assess the Feasibility and Oncologic Safety of Axillary Reverse Mapping in Breast Cancer Patients
Auteurs : Isabelle Bedrosian ; Gildy V. Babiera ; Elizabeth A. Mittendorf ; Henry M. Kuerer ; Laura Pantoja ; Kelly K. Hunt ; Savitri Krishnamurthy ; Funda Meric-BernstamSource :
- Cancer [ 0008-543X ] ; 2010.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
Abstract
BACKGROUND: Axillary reverse mapping (ARM) is a novel technique to preserve upper extremity lymphatics that may reduce the incidence of lymphedema after axillary lymph node dissection. Early reports have suggested that ARM lymph nodes do not contain metastatic disease from breast cancer; however, these studies were conducted in early stage patients with low likelihood of lymph node metastasis. This study reported a phase 1 trial conducted in patients with cytologically documented axillary metastasis undergoing axillary lymph node dissection to determine the feasibility and oncologic safety of ARM. METHODS: Thirty patients, 23 (77%) of whom received preoperative therapy (chemotherapy in 22 patients and hormonal therapy in 1 patient), were enrolled. Blue dye was injected in the upper inner ipsilateral arm. The presence of blue lymphatics was noted, and blue lymph nodes were sent separately for pathologic evaluation. RESULTS: The average time between blue dye injection and axillary exposure was 35 minutes (range, 15-60 minutes). Blue lymphatics were identified in 21 patients (70%) and blue lymph nodes in 15 patients (50%). The median number of ARM lymph nodes was 1 (range, 0-3 lymph nodes) and the median number of axillary lymph nodes was 26 (range, 6-47 lymph nodes). Axillary metastases were noted in 60% (18 of 30) of patients. Of 11 patients who had axillary metastasis and at least 1 ARM lymph node identified, 2 (18%) had metastasis to the ARM lymph node. CONCLUSIONS: ARM appears to be a feasible technique with which to identify upper arm lymphatics during axillary surgery. However, the high prevalence of disease involving ARM lymph nodes in this small cohort suggested that preservation of these lymphatics is not oncologically safe in women with documented axillary lymph node metastasis from breast cancer.
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Format Inist (serveur)
NO : | PASCAL 10-0275226 INIST |
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ET : | A Phase I Study to Assess the Feasibility and Oncologic Safety of Axillary Reverse Mapping in Breast Cancer Patients |
AU : | BEDROSIAN (Isabelle); BABIERA (Gildy V.); MITTENDORF (Elizabeth A.); KUERER (Henry M.); PANTOJA (Laura); HUNT (Kelly K.); KRISHNAMURTHY (Savitri); MERIC-BERNSTAM (Funda) |
AF : | Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center/Houston Texas/Etats-Unis (1 aut., 2 aut., 3 aut., 4 aut., 5 aut., 6 aut., 8 aut.); Department of Pathology, The University of Texas M. D. Anderson Cancer Center/Houston Texas/Etats-Unis (7 aut.) |
DT : | Publication en série; Niveau analytique |
SO : | Cancer; ISSN 0008-543X; Coden CANCAR; Etats-Unis; Da. 2010; Vol. 116; No. 11; Pp. 2543-2548; Bibl. 13 ref. |
LA : | Anglais |
EA : | BACKGROUND: Axillary reverse mapping (ARM) is a novel technique to preserve upper extremity lymphatics that may reduce the incidence of lymphedema after axillary lymph node dissection. Early reports have suggested that ARM lymph nodes do not contain metastatic disease from breast cancer; however, these studies were conducted in early stage patients with low likelihood of lymph node metastasis. This study reported a phase 1 trial conducted in patients with cytologically documented axillary metastasis undergoing axillary lymph node dissection to determine the feasibility and oncologic safety of ARM. METHODS: Thirty patients, 23 (77%) of whom received preoperative therapy (chemotherapy in 22 patients and hormonal therapy in 1 patient), were enrolled. Blue dye was injected in the upper inner ipsilateral arm. The presence of blue lymphatics was noted, and blue lymph nodes were sent separately for pathologic evaluation. RESULTS: The average time between blue dye injection and axillary exposure was 35 minutes (range, 15-60 minutes). Blue lymphatics were identified in 21 patients (70%) and blue lymph nodes in 15 patients (50%). The median number of ARM lymph nodes was 1 (range, 0-3 lymph nodes) and the median number of axillary lymph nodes was 26 (range, 6-47 lymph nodes). Axillary metastases were noted in 60% (18 of 30) of patients. Of 11 patients who had axillary metastasis and at least 1 ARM lymph node identified, 2 (18%) had metastasis to the ARM lymph node. CONCLUSIONS: ARM appears to be a feasible technique with which to identify upper arm lymphatics during axillary surgery. However, the high prevalence of disease involving ARM lymph nodes in this small cohort suggested that preservation of these lymphatics is not oncologically safe in women with documented axillary lymph node metastasis from breast cancer. |
CC : | 002B04; 002B20E02 |
FD : | Essai clinique phase I; Traitement; Faisabilité; Cartographie; Axillaire; Réversibilité; Cancer du sein; Homme; Creux axillaire; Lymphoedème; Lymphadénectomie; Essai clinique; Cancérologie |
FG : | Tumeur maligne; Cancer; Pathologie de la glande mammaire; Pathologie du sein; Pathologie de l'appareil circulatoire; Pathologie des vaisseaux lymphatiques; Chirurgie |
ED : | Phase I trial; Treatment; Feasibility; Cartography; Axillary; Reversibility; Breast cancer; Human; Axilla; Lymphedema; Lymphadenectomy; Clinical trial; Cancerology |
EG : | Malignant tumor; Cancer; Mammary gland diseases; Breast disease; Cardiovascular disease; Lymphatic vessel disease; Surgery |
SD : | Ensayo clínico fase I; Tratamiento; Practicabilidad; Cartografía; Axilar; Reversibilidad; Cáncer del pecho; Hombre; Axila; Linfedema; Linfadenectomía; Ensayo clínico; Cancerología |
LO : | INIST-2701.354000193002280050 |
ID : | 10-0275226 |
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Pascal:10-0275226Le document en format XML
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<term>Cartography</term>
<term>Clinical trial</term>
<term>Feasibility</term>
<term>Human</term>
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<term>Lymphedema</term>
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<front><div type="abstract" xml:lang="en">BACKGROUND: Axillary reverse mapping (ARM) is a novel technique to preserve upper extremity lymphatics that may reduce the incidence of lymphedema after axillary lymph node dissection. Early reports have suggested that ARM lymph nodes do not contain metastatic disease from breast cancer; however, these studies were conducted in early stage patients with low likelihood of lymph node metastasis. This study reported a phase 1 trial conducted in patients with cytologically documented axillary metastasis undergoing axillary lymph node dissection to determine the feasibility and oncologic safety of ARM. METHODS: Thirty patients, 23 (77%) of whom received preoperative therapy (chemotherapy in 22 patients and hormonal therapy in 1 patient), were enrolled. Blue dye was injected in the upper inner ipsilateral arm. The presence of blue lymphatics was noted, and blue lymph nodes were sent separately for pathologic evaluation. RESULTS: The average time between blue dye injection and axillary exposure was 35 minutes (range, 15-60 minutes). Blue lymphatics were identified in 21 patients (70%) and blue lymph nodes in 15 patients (50%). The median number of ARM lymph nodes was 1 (range, 0-3 lymph nodes) and the median number of axillary lymph nodes was 26 (range, 6-47 lymph nodes). Axillary metastases were noted in 60% (18 of 30) of patients. Of 11 patients who had axillary metastasis and at least 1 ARM lymph node identified, 2 (18%) had metastasis to the ARM lymph node. CONCLUSIONS: ARM appears to be a feasible technique with which to identify upper arm lymphatics during axillary surgery. However, the high prevalence of disease involving ARM lymph nodes in this small cohort suggested that preservation of these lymphatics is not oncologically safe in women with documented axillary lymph node metastasis from breast cancer.</div>
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<fC01 i1="01" l="ENG"><s0>BACKGROUND: Axillary reverse mapping (ARM) is a novel technique to preserve upper extremity lymphatics that may reduce the incidence of lymphedema after axillary lymph node dissection. Early reports have suggested that ARM lymph nodes do not contain metastatic disease from breast cancer; however, these studies were conducted in early stage patients with low likelihood of lymph node metastasis. This study reported a phase 1 trial conducted in patients with cytologically documented axillary metastasis undergoing axillary lymph node dissection to determine the feasibility and oncologic safety of ARM. METHODS: Thirty patients, 23 (77%) of whom received preoperative therapy (chemotherapy in 22 patients and hormonal therapy in 1 patient), were enrolled. Blue dye was injected in the upper inner ipsilateral arm. The presence of blue lymphatics was noted, and blue lymph nodes were sent separately for pathologic evaluation. RESULTS: The average time between blue dye injection and axillary exposure was 35 minutes (range, 15-60 minutes). Blue lymphatics were identified in 21 patients (70%) and blue lymph nodes in 15 patients (50%). The median number of ARM lymph nodes was 1 (range, 0-3 lymph nodes) and the median number of axillary lymph nodes was 26 (range, 6-47 lymph nodes). Axillary metastases were noted in 60% (18 of 30) of patients. Of 11 patients who had axillary metastasis and at least 1 ARM lymph node identified, 2 (18%) had metastasis to the ARM lymph node. CONCLUSIONS: ARM appears to be a feasible technique with which to identify upper arm lymphatics during axillary surgery. However, the high prevalence of disease involving ARM lymph nodes in this small cohort suggested that preservation of these lymphatics is not oncologically safe in women with documented axillary lymph node metastasis from breast cancer.</s0>
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<fC03 i1="03" i2="X" l="SPA"><s0>Practicabilidad</s0>
<s5>03</s5>
</fC03>
<fC03 i1="04" i2="X" l="FRE"><s0>Cartographie</s0>
<s5>04</s5>
</fC03>
<fC03 i1="04" i2="X" l="ENG"><s0>Cartography</s0>
<s5>04</s5>
</fC03>
<fC03 i1="04" i2="X" l="SPA"><s0>Cartografía</s0>
<s5>04</s5>
</fC03>
<fC03 i1="05" i2="X" l="FRE"><s0>Axillaire</s0>
<s5>05</s5>
</fC03>
<fC03 i1="05" i2="X" l="ENG"><s0>Axillary</s0>
<s5>05</s5>
</fC03>
<fC03 i1="05" i2="X" l="SPA"><s0>Axilar</s0>
<s5>05</s5>
</fC03>
<fC03 i1="06" i2="X" l="FRE"><s0>Réversibilité</s0>
<s5>06</s5>
</fC03>
<fC03 i1="06" i2="X" l="ENG"><s0>Reversibility</s0>
<s5>06</s5>
</fC03>
<fC03 i1="06" i2="X" l="SPA"><s0>Reversibilidad</s0>
<s5>06</s5>
</fC03>
<fC03 i1="07" i2="X" l="FRE"><s0>Cancer du sein</s0>
<s2>NM</s2>
<s5>07</s5>
</fC03>
<fC03 i1="07" i2="X" l="ENG"><s0>Breast cancer</s0>
<s2>NM</s2>
<s5>07</s5>
</fC03>
<fC03 i1="07" i2="X" l="SPA"><s0>Cáncer del pecho</s0>
<s2>NM</s2>
<s5>07</s5>
</fC03>
<fC03 i1="08" i2="X" l="FRE"><s0>Homme</s0>
<s5>08</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG"><s0>Human</s0>
<s5>08</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA"><s0>Hombre</s0>
<s5>08</s5>
</fC03>
<fC03 i1="09" i2="X" l="FRE"><s0>Creux axillaire</s0>
<s5>09</s5>
</fC03>
<fC03 i1="09" i2="X" l="ENG"><s0>Axilla</s0>
<s5>09</s5>
</fC03>
<fC03 i1="09" i2="X" l="SPA"><s0>Axila</s0>
<s5>09</s5>
</fC03>
<fC03 i1="10" i2="X" l="FRE"><s0>Lymphoedème</s0>
<s5>10</s5>
</fC03>
<fC03 i1="10" i2="X" l="ENG"><s0>Lymphedema</s0>
<s5>10</s5>
</fC03>
<fC03 i1="10" i2="X" l="SPA"><s0>Linfedema</s0>
<s5>10</s5>
</fC03>
<fC03 i1="11" i2="X" l="FRE"><s0>Lymphadénectomie</s0>
<s5>11</s5>
</fC03>
<fC03 i1="11" i2="X" l="ENG"><s0>Lymphadenectomy</s0>
<s5>11</s5>
</fC03>
<fC03 i1="11" i2="X" l="SPA"><s0>Linfadenectomía</s0>
<s5>11</s5>
</fC03>
<fC03 i1="12" i2="X" l="FRE"><s0>Essai clinique</s0>
<s5>12</s5>
</fC03>
<fC03 i1="12" i2="X" l="ENG"><s0>Clinical trial</s0>
<s5>12</s5>
</fC03>
<fC03 i1="12" i2="X" l="SPA"><s0>Ensayo clínico</s0>
<s5>12</s5>
</fC03>
<fC03 i1="13" i2="X" l="FRE"><s0>Cancérologie</s0>
<s5>17</s5>
</fC03>
<fC03 i1="13" i2="X" l="ENG"><s0>Cancerology</s0>
<s5>17</s5>
</fC03>
<fC03 i1="13" i2="X" l="SPA"><s0>Cancerología</s0>
<s5>17</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE"><s0>Tumeur maligne</s0>
<s2>NM</s2>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="ENG"><s0>Malignant tumor</s0>
<s2>NM</s2>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="SPA"><s0>Tumor maligno</s0>
<s2>NM</s2>
<s5>37</s5>
</fC07>
<fC07 i1="02" i2="X" l="FRE"><s0>Cancer</s0>
<s2>NM</s2>
</fC07>
<fC07 i1="02" i2="X" l="ENG"><s0>Cancer</s0>
<s2>NM</s2>
</fC07>
<fC07 i1="02" i2="X" l="SPA"><s0>Cáncer</s0>
<s2>NM</s2>
</fC07>
<fC07 i1="03" i2="X" l="FRE"><s0>Pathologie de la glande mammaire</s0>
<s2>NM</s2>
<s5>38</s5>
</fC07>
<fC07 i1="03" i2="X" l="ENG"><s0>Mammary gland diseases</s0>
<s2>NM</s2>
<s5>38</s5>
</fC07>
<fC07 i1="03" i2="X" l="SPA"><s0>Glándula mamaria patología</s0>
<s2>NM</s2>
<s5>38</s5>
</fC07>
<fC07 i1="04" i2="X" l="FRE"><s0>Pathologie du sein</s0>
<s2>NM</s2>
<s5>39</s5>
</fC07>
<fC07 i1="04" i2="X" l="ENG"><s0>Breast disease</s0>
<s2>NM</s2>
<s5>39</s5>
</fC07>
<fC07 i1="04" i2="X" l="SPA"><s0>Seno patología</s0>
<s2>NM</s2>
<s5>39</s5>
</fC07>
<fC07 i1="05" i2="X" l="FRE"><s0>Pathologie de l'appareil circulatoire</s0>
<s5>40</s5>
</fC07>
<fC07 i1="05" i2="X" l="ENG"><s0>Cardiovascular disease</s0>
<s5>40</s5>
</fC07>
<fC07 i1="05" i2="X" l="SPA"><s0>Aparato circulatorio patología</s0>
<s5>40</s5>
</fC07>
<fC07 i1="06" i2="X" l="FRE"><s0>Pathologie des vaisseaux lymphatiques</s0>
<s5>41</s5>
</fC07>
<fC07 i1="06" i2="X" l="ENG"><s0>Lymphatic vessel disease</s0>
<s5>41</s5>
</fC07>
<fC07 i1="06" i2="X" l="SPA"><s0>Linfático patología</s0>
<s5>41</s5>
</fC07>
<fC07 i1="07" i2="X" l="FRE"><s0>Chirurgie</s0>
<s5>42</s5>
</fC07>
<fC07 i1="07" i2="X" l="ENG"><s0>Surgery</s0>
<s5>42</s5>
</fC07>
<fC07 i1="07" i2="X" l="SPA"><s0>Cirugía</s0>
<s5>42</s5>
</fC07>
<fN21><s1>181</s1>
</fN21>
<fN44 i1="01"><s1>OTO</s1>
</fN44>
<fN82><s1>OTO</s1>
</fN82>
</pA>
</standard>
<server><NO>PASCAL 10-0275226 INIST</NO>
<ET>A Phase I Study to Assess the Feasibility and Oncologic Safety of Axillary Reverse Mapping in Breast Cancer Patients</ET>
<AU>BEDROSIAN (Isabelle); BABIERA (Gildy V.); MITTENDORF (Elizabeth A.); KUERER (Henry M.); PANTOJA (Laura); HUNT (Kelly K.); KRISHNAMURTHY (Savitri); MERIC-BERNSTAM (Funda)</AU>
<AF>Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center/Houston Texas/Etats-Unis (1 aut., 2 aut., 3 aut., 4 aut., 5 aut., 6 aut., 8 aut.); Department of Pathology, The University of Texas M. D. Anderson Cancer Center/Houston Texas/Etats-Unis (7 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>Cancer; ISSN 0008-543X; Coden CANCAR; Etats-Unis; Da. 2010; Vol. 116; No. 11; Pp. 2543-2548; Bibl. 13 ref.</SO>
<LA>Anglais</LA>
<EA>BACKGROUND: Axillary reverse mapping (ARM) is a novel technique to preserve upper extremity lymphatics that may reduce the incidence of lymphedema after axillary lymph node dissection. Early reports have suggested that ARM lymph nodes do not contain metastatic disease from breast cancer; however, these studies were conducted in early stage patients with low likelihood of lymph node metastasis. This study reported a phase 1 trial conducted in patients with cytologically documented axillary metastasis undergoing axillary lymph node dissection to determine the feasibility and oncologic safety of ARM. METHODS: Thirty patients, 23 (77%) of whom received preoperative therapy (chemotherapy in 22 patients and hormonal therapy in 1 patient), were enrolled. Blue dye was injected in the upper inner ipsilateral arm. The presence of blue lymphatics was noted, and blue lymph nodes were sent separately for pathologic evaluation. RESULTS: The average time between blue dye injection and axillary exposure was 35 minutes (range, 15-60 minutes). Blue lymphatics were identified in 21 patients (70%) and blue lymph nodes in 15 patients (50%). The median number of ARM lymph nodes was 1 (range, 0-3 lymph nodes) and the median number of axillary lymph nodes was 26 (range, 6-47 lymph nodes). Axillary metastases were noted in 60% (18 of 30) of patients. Of 11 patients who had axillary metastasis and at least 1 ARM lymph node identified, 2 (18%) had metastasis to the ARM lymph node. CONCLUSIONS: ARM appears to be a feasible technique with which to identify upper arm lymphatics during axillary surgery. However, the high prevalence of disease involving ARM lymph nodes in this small cohort suggested that preservation of these lymphatics is not oncologically safe in women with documented axillary lymph node metastasis from breast cancer.</EA>
<CC>002B04; 002B20E02</CC>
<FD>Essai clinique phase I; Traitement; Faisabilité; Cartographie; Axillaire; Réversibilité; Cancer du sein; Homme; Creux axillaire; Lymphoedème; Lymphadénectomie; Essai clinique; Cancérologie</FD>
<FG>Tumeur maligne; Cancer; Pathologie de la glande mammaire; Pathologie du sein; Pathologie de l'appareil circulatoire; Pathologie des vaisseaux lymphatiques; Chirurgie</FG>
<ED>Phase I trial; Treatment; Feasibility; Cartography; Axillary; Reversibility; Breast cancer; Human; Axilla; Lymphedema; Lymphadenectomy; Clinical trial; Cancerology</ED>
<EG>Malignant tumor; Cancer; Mammary gland diseases; Breast disease; Cardiovascular disease; Lymphatic vessel disease; Surgery</EG>
<SD>Ensayo clínico fase I; Tratamiento; Practicabilidad; Cartografía; Axilar; Reversibilidad; Cáncer del pecho; Hombre; Axila; Linfedema; Linfadenectomía; Ensayo clínico; Cancerología</SD>
<LO>INIST-2701.354000193002280050</LO>
<ID>10-0275226</ID>
</server>
</inist>
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