Is Axillary Reverse Mapping Oncologically Safe in Breast Cancer Surgery?

Objective: Axillary reverse mapping (ARM) has been described to protect against lymphedema.This study aimed to explore the oncological safety of ARM in terms of tumor characteristics and other factors. Methods:The study included 81 patients who received mastectomy or breast-conserving surgery for diagnosis of breast cancer and undergo ARM as clinically axillary positive disease. Results:No axillary reverse mapping lymph node (ARMLN) was found for 26 patients (32%).Of the 55 patients with ARMLN, 19 (34%) were malignant and 36 (66%) were benign.A statistically significant relationship was found between ARMLN and the number of lymph nodes dissected (p=0.004).The larger the size of ARMLN dissected, the more likely it is that the lymph nodes will be malignant (p=0.001). Conclusion:Our study suggests that the higher the axillary burden, the more likely it is for ARMLN to be malignant and the less safe its preservation.Additional randomized prospective studies with a focus on patient survival time and recurrence are warranted to verify the potential feasibility of the ARM technique and confirm the reliability of the reported protocols.