title: Axillary reverse mapping in breast cancer: a Canadian experience.
abstract: BACKGROUND
  The aim of this study was to evaluate the axillary reverse lymphatic mapping (ARM) procedure for reducing the risk of arm lymphedema after breast cancer surgery.
  
  
  METHODS
  The ARM procedure was carried out with a subareolar injection of technetium-99 sulfur colloid the morning of surgery, and a patent blue dye injection into the upper inner arm after anesthesia.
  
  
  RESULTS
  Fifty-two women made up our study population. Thirty-seven patients underwent sentinel lymph node biopsy (SLNB) and 15 patients underwent an axillary lymph node dissection (ALND) for known nodal metastasis. The sentinel lymph node was identified in 36 of the 37 cases who underwent SLNB alone and in 12 of 15 patients who underwent on ALND. In 13 patients, both blue and radioactive lymph nodes or lymphatics were clearly identified (25%) and 5 patients had a clear crossover with nodes being both blue and hot. Only a single patient with crossover lymphatics had metastases present in their sentinel node.
  
  
  CONCLUSIONS
  The ARM technique did not prevent identification of the SLN and we identified much greater crossover than reported. We had a single patient, who underwent a sentinel node biopsy, with mild arm lymphedema (1.9%) after 2 years of follow up.
authors: Department of Surgery, Mount St. Joseph's Hospital, University of British Columbia, Vancouver, British Columbia, Canada; Department of Surgery, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
authors: Urve
authors: U
authors: Kuusk
authors: Nazgol
authors: N
authors: Seyednejad
authors: Elaine C
authors: EC
authors: McKevitt
authors: Carol K
authors: CK
authors: Dingee
authors: Sam M
authors: SM
authors: Wiseman
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D001365:Axilla; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008209:Lymphedema / Q000517:prevention & control; D008408:Mastectomy; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D011877:Radionuclide Imaging; D021701:Sentinel Lymph Node Biopsy; D013671:Technetium Tc 99m Sulfur Colloid
chemical_list: D013671:Technetium Tc 99m Sulfur Colloid
keywords: complications; lymphatic mapping; lymphedema; sentinel lymph node biopsy