LymphedemaV1, PascalFrancis, Corpus, bibRecord, 000247

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 : 000248

A 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-Bernstam

Source :

Cancer [ 0008-543X ] ; 2010.

RBID : Pascal:10-0275226

Descripteurs français

Pascal (Inist)
- Essai clinique phase I, Traitement, Faisabilité, Cartographie, Axillaire, Réversibilité, Cancer du sein, Homme, Creux axillaire, Lymphoedème, Lymphadénectomie, Essai clinique, Cancérologie.

English descriptors

KwdEn :
- Axilla, Axillary, Breast cancer, Cancerology, Cartography, Clinical trial, Feasibility, Human, Lymphadenectomy, Lymphedema, Phase I trial, Reversibility, Treatment.

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.

Notice en format standard (ISO 2709)

Pour connaître la documentation sur le format Inist Standard.

A01	`01`	`1`		`@0 0008-543X`
A02	`01`			`@0 CANCAR`
A03		`1`		`@0 Cancer`
A05				`@2 116`
A06				`@2 11`
A08	`01`	`1`	`ENG`	`@1 A Phase I Study to Assess the Feasibility and Oncologic Safety of Axillary Reverse Mapping in Breast Cancer Patients`
A11	`01`	`1`		`@1 BEDROSIAN (Isabelle)`
A11	`02`	`1`		`@1 BABIERA (Gildy V.)`
A11	`03`	`1`		`@1 MITTENDORF (Elizabeth A.)`
A11	`04`	`1`		`@1 KUERER (Henry M.)`
A11	`05`	`1`		`@1 PANTOJA (Laura)`
A11	`06`	`1`		`@1 HUNT (Kelly K.)`
A11	`07`	`1`		`@1 KRISHNAMURTHY (Savitri)`
A11	`08`	`1`		`@1 MERIC-BERNSTAM (Funda)`
A14	`01`			`@1 Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center @2 Houston Texas @3 USA @Z 1 aut. @Z 2 aut. @Z 3 aut. @Z 4 aut. @Z 5 aut. @Z 6 aut. @Z 8 aut.`
A14	`02`			`@1 Department of Pathology, The University of Texas M. D. Anderson Cancer Center @2 Houston Texas @3 USA @Z 7 aut.`
A20				`@1 2543-2548`
A21				`@1 2010`
A23	`01`			`@0 ENG`
A43	`01`			`@1 INIST @2 2701 @5 354000193002280050`
A44				`@0 0000 @1 © 2010 INIST-CNRS. All rights reserved.`
A45				`@0 13 ref.`
A47	`01`	`1`		`@0 10-0275226`
A60				`@1 P`
A61				`@0 A`
A64	`01`	`1`		`@0 Cancer`
A66	`01`			`@0 USA`
C01	`01`		`ENG`	@0 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.
C02	`01`	`X`		`@0 002B04`
C02	`02`	`X`		`@0 002B20E02`
C03	`01`	`X`	`FRE`	`@0 Essai clinique phase I @5 01`
C03	`01`	`X`	`ENG`	`@0 Phase I trial @5 01`
C03	`01`	`X`	`SPA`	`@0 Ensayo clínico fase I @5 01`
C03	`02`	`X`	`FRE`	`@0 Traitement @5 02`
C03	`02`	`X`	`ENG`	`@0 Treatment @5 02`
C03	`02`	`X`	`SPA`	`@0 Tratamiento @5 02`
C03	`03`	`X`	`FRE`	`@0 Faisabilité @5 03`
C03	`03`	`X`	`ENG`	`@0 Feasibility @5 03`
C03	`03`	`X`	`SPA`	`@0 Practicabilidad @5 03`
C03	`04`	`X`	`FRE`	`@0 Cartographie @5 04`
C03	`04`	`X`	`ENG`	`@0 Cartography @5 04`
C03	`04`	`X`	`SPA`	`@0 Cartografía @5 04`
C03	`05`	`X`	`FRE`	`@0 Axillaire @5 05`
C03	`05`	`X`	`ENG`	`@0 Axillary @5 05`
C03	`05`	`X`	`SPA`	`@0 Axilar @5 05`
C03	`06`	`X`	`FRE`	`@0 Réversibilité @5 06`
C03	`06`	`X`	`ENG`	`@0 Reversibility @5 06`
C03	`06`	`X`	`SPA`	`@0 Reversibilidad @5 06`
C03	`07`	`X`	`FRE`	`@0 Cancer du sein @2 NM @5 07`
C03	`07`	`X`	`ENG`	`@0 Breast cancer @2 NM @5 07`
C03	`07`	`X`	`SPA`	`@0 Cáncer del pecho @2 NM @5 07`
C03	`08`	`X`	`FRE`	`@0 Homme @5 08`
C03	`08`	`X`	`ENG`	`@0 Human @5 08`
C03	`08`	`X`	`SPA`	`@0 Hombre @5 08`
C03	`09`	`X`	`FRE`	`@0 Creux axillaire @5 09`
C03	`09`	`X`	`ENG`	`@0 Axilla @5 09`
C03	`09`	`X`	`SPA`	`@0 Axila @5 09`
C03	`10`	`X`	`FRE`	`@0 Lymphoedème @5 10`
C03	`10`	`X`	`ENG`	`@0 Lymphedema @5 10`
C03	`10`	`X`	`SPA`	`@0 Linfedema @5 10`
C03	`11`	`X`	`FRE`	`@0 Lymphadénectomie @5 11`
C03	`11`	`X`	`ENG`	`@0 Lymphadenectomy @5 11`
C03	`11`	`X`	`SPA`	`@0 Linfadenectomía @5 11`
C03	`12`	`X`	`FRE`	`@0 Essai clinique @5 12`
C03	`12`	`X`	`ENG`	`@0 Clinical trial @5 12`
C03	`12`	`X`	`SPA`	`@0 Ensayo clínico @5 12`
C03	`13`	`X`	`FRE`	`@0 Cancérologie @5 17`
C03	`13`	`X`	`ENG`	`@0 Cancerology @5 17`
C03	`13`	`X`	`SPA`	`@0 Cancerología @5 17`
C07	`01`	`X`	`FRE`	`@0 Tumeur maligne @2 NM @5 37`
C07	`01`	`X`	`ENG`	`@0 Malignant tumor @2 NM @5 37`
C07	`01`	`X`	`SPA`	`@0 Tumor maligno @2 NM @5 37`
C07	`02`	`X`	`FRE`	`@0 Cancer @2 NM`
C07	`02`	`X`	`ENG`	`@0 Cancer @2 NM`
C07	`02`	`X`	`SPA`	`@0 Cáncer @2 NM`
C07	`03`	`X`	`FRE`	`@0 Pathologie de la glande mammaire @2 NM @5 38`
C07	`03`	`X`	`ENG`	`@0 Mammary gland diseases @2 NM @5 38`
C07	`03`	`X`	`SPA`	`@0 Glándula mamaria patología @2 NM @5 38`
C07	`04`	`X`	`FRE`	`@0 Pathologie du sein @2 NM @5 39`
C07	`04`	`X`	`ENG`	`@0 Breast disease @2 NM @5 39`
C07	`04`	`X`	`SPA`	`@0 Seno patología @2 NM @5 39`
C07	`05`	`X`	`FRE`	`@0 Pathologie de l'appareil circulatoire @5 40`
C07	`05`	`X`	`ENG`	`@0 Cardiovascular disease @5 40`
C07	`05`	`X`	`SPA`	`@0 Aparato circulatorio patología @5 40`
C07	`06`	`X`	`FRE`	`@0 Pathologie des vaisseaux lymphatiques @5 41`
C07	`06`	`X`	`ENG`	`@0 Lymphatic vessel disease @5 41`
C07	`06`	`X`	`SPA`	`@0 Linfático patología @5 41`
C07	`07`	`X`	`FRE`	`@0 Chirurgie @5 42`
C07	`07`	`X`	`ENG`	`@0 Surgery @5 42`
C07	`07`	`X`	`SPA`	`@0 Cirugía @5 42`
N21				`@1 181`
N44	`01`			`@1 OTO`
N82				`@1 OTO`

Format Inist (serveur)

NO :	PASCAL 10-0275226 INIST
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

Links to Exploration step

Pascal:10-0275226

Le document en format XML

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<author><name sortKey="Meric Bernstam, Funda" sort="Meric Bernstam, Funda" uniqKey="Meric Bernstam F" first="Funda" last="Meric-Bernstam">Funda Meric-Bernstam</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">A Phase I Study to Assess the Feasibility and Oncologic Safety of Axillary Reverse Mapping in Breast Cancer Patients</title>
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<author><name sortKey="Kuerer, Henry M" sort="Kuerer, Henry M" uniqKey="Kuerer H" first="Henry M." last="Kuerer">Henry M. Kuerer</name>
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<author><name sortKey="Pantoja, Laura" sort="Pantoja, Laura" uniqKey="Pantoja L" first="Laura" last="Pantoja">Laura Pantoja</name>
<affiliation><inist:fA14 i1="01"><s1>Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center</s1>
<s2>Houston Texas</s2>
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<author><name sortKey="Hunt, Kelly K" sort="Hunt, Kelly K" uniqKey="Hunt K" first="Kelly K." last="Hunt">Kelly K. Hunt</name>
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<s2>Houston Texas</s2>
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<author><name sortKey="Krishnamurthy, Savitri" sort="Krishnamurthy, Savitri" uniqKey="Krishnamurthy S" first="Savitri" last="Krishnamurthy">Savitri Krishnamurthy</name>
<affiliation><inist:fA14 i1="02"><s1>Department of Pathology, The University of Texas M. D. Anderson Cancer Center</s1>
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<author><name sortKey="Meric Bernstam, Funda" sort="Meric Bernstam, Funda" uniqKey="Meric Bernstam F" first="Funda" last="Meric-Bernstam">Funda Meric-Bernstam</name>
<affiliation><inist:fA14 i1="01"><s1>Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center</s1>
<s2>Houston Texas</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>3 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>6 aut.</sZ>
<sZ>8 aut.</sZ>
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<series><title level="j" type="main">Cancer</title>
<title level="j" type="abbreviated">Cancer</title>
<idno type="ISSN">0008-543X</idno>
<imprint><date when="2010">2010</date>
</imprint>
</series>
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<seriesStmt><title level="j" type="main">Cancer</title>
<title level="j" type="abbreviated">Cancer</title>
<idno type="ISSN">0008-543X</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Axilla</term>
<term>Axillary</term>
<term>Breast cancer</term>
<term>Cancerology</term>
<term>Cartography</term>
<term>Clinical trial</term>
<term>Feasibility</term>
<term>Human</term>
<term>Lymphadenectomy</term>
<term>Lymphedema</term>
<term>Phase I trial</term>
<term>Reversibility</term>
<term>Treatment</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Essai clinique phase I</term>
<term>Traitement</term>
<term>Faisabilité</term>
<term>Cartographie</term>
<term>Axillaire</term>
<term>Réversibilité</term>
<term>Cancer du sein</term>
<term>Homme</term>
<term>Creux axillaire</term>
<term>Lymphoedème</term>
<term>Lymphadénectomie</term>
<term>Essai clinique</term>
<term>Cancérologie</term>
</keywords>
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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>
</front>
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<fA11 i1="03" i2="1"><s1>MITTENDORF (Elizabeth A.)</s1>
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<fA11 i1="04" i2="1"><s1>KUERER (Henry M.)</s1>
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<fA11 i1="05" i2="1"><s1>PANTOJA (Laura)</s1>
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<fA11 i1="06" i2="1"><s1>HUNT (Kelly K.)</s1>
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<fA11 i1="07" i2="1"><s1>KRISHNAMURTHY (Savitri)</s1>
</fA11>
<fA11 i1="08" i2="1"><s1>MERIC-BERNSTAM (Funda)</s1>
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<fA14 i1="01"><s1>Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center</s1>
<s2>Houston Texas</s2>
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<sZ>2 aut.</sZ>
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<sZ>5 aut.</sZ>
<sZ>6 aut.</sZ>
<sZ>8 aut.</sZ>
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<fA14 i1="02"><s1>Department of Pathology, The University of Texas M. D. Anderson Cancer Center</s1>
<s2>Houston Texas</s2>
<s3>USA</s3>
<sZ>7 aut.</sZ>
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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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<s5>07</s5>
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<s5>07</s5>
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<s5>11</s5>
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<s5>11</s5>
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<fC03 i1="11" i2="X" l="SPA"><s0>Linfadenectomía</s0>
<s5>11</s5>
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<s5>12</s5>
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<s2>NM</s2>
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<s5>40</s5>
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<s5>41</s5>
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<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>
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<ID>10-0275226</ID>
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A Phase I Study to Assess the Feasibility and Oncologic Safety of Axillary Reverse Mapping in Breast Cancer Patients

A Phase I Study to Assess the Feasibility and Oncologic Safety of Axillary Reverse Mapping in Breast Cancer Patients

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