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The Feasibility and Oncological Safety of Axillary Reverse Mapping in Patients with Breast Cancer: A Systematic Review and Meta-Analysis of Prospective Studies
- Source :
- PLoS ONE, Vol 11, Iss 2, p e0150285 (2016), PLoS ONE
- Publication Year :
- 2016
- Publisher :
- Public Library of Science (PLoS), 2016.
-
Abstract
- Objective The axillary reverse mapping (ARM) technique has recently been developed to prevent lymphedema by preserving the arm lymphatic drainage during sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND) procedures. The objective of this systematic review and meta-analysis was to evaluate the feasibility and oncological safety of ARM. Methods We searched Medline, Embase, Web of science, Scopus, and the Cochrane Library for relevant prospective studies. The identification rate of ARM nodes, the crossover rate of SLN-ARM nodes, the proportion of metastatic ARM nodes, and the incidence of complications were pooled into meta-analyses by the random-effects model. Results A total of 24 prospective studies were included into meta-analyses, of which 11 studies reported ARM during SLNB, and 18 studies reported ARM during SLNB. The overall identification rate of ARM nodes was 38.2% (95% CI 32.9%-43.8%) during SLNB and 82.8% (78.0%-86.6%) during ALND, respectively. The crossover rate of SLN-ARM nodes was 19.6% (95% CI 14.4%-26.1%). The metastatic rate of ARM nodes was 16.9% (95% CI 14.2%-20.1%). The pooled incidence of lymphedema was 4.1% (95% CI 2.9–5.9%) for patients undergoing ARM procedure. Conclusions The ARM procedure was feasible during ALND. Nevertheless, it was restricted by low identification rate of ARM nodes during SLNB. ARM was beneficial for preventing lymphedema. However, this technique should be performed with caution given the possibility of crossover SLN-ARM nodes and metastatic ARM nodes. ARM appeared to be unsuitable for patients with clinically positive breast cancer due to oncological safety concern.
- Subjects :
- Pigments
lcsh:Medicine
Cochrane Library
Pathology and Laboratory Medicine
Metastasis
0302 clinical medicine
Mathematical and Statistical Techniques
Basic Cancer Research
Breast Tumors
Medicine and Health Sciences
Edema
030212 general & internal medicine
Lymphedema
Prospective Studies
Prospective cohort study
Coloring Agents
lcsh:Science
Musculoskeletal System
Dyes
Multidisciplinary
Arms
medicine.anatomical_structure
Oncology
030220 oncology & carcinogenesis
Meta-analysis
Lymphatic Metastasis
Physical Sciences
Arm
Female
Anatomy
Statistics (Mathematics)
Research Article
medicine.medical_specialty
Injections, Intradermal
Lymphatic Mapping
Sentinel lymph node
Materials Science
Breast Neoplasms
Research and Analysis Methods
Lymphatic System
03 medical and health sciences
Breast cancer
Signs and Symptoms
Preoperative Care
Breast Cancer
medicine
Cancer Detection and Diagnosis
Humans
Statistical Methods
Materials by Attribute
Lymphatic Vessels
Fluorescent Dyes
business.industry
Sentinel Lymph Node Biopsy
Limbs (Anatomy)
lcsh:R
Axillary Lymph Node Dissection
Biology and Life Sciences
Cancers and Neoplasms
medicine.disease
Surgery
Axilla
Feasibility Studies
Lymph Node Excision
lcsh:Q
Lymph Nodes
business
Mathematics
Meta-Analysis
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 11
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.doi.dedup.....212b200173a23929bc452a13226c278e