The Feasibility and Oncological Safety of Axillary Reverse Mapping in Patients with Breast Cancer: A Systematic Review and Meta-Analysis of Prospective Studies
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 evalu...
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| creator | Han, Chao Yang, Ben Zuo, Wen-Shu Zheng, Gang Yang, Li Zheng, Mei-Zhu |
| description | 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.
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.
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.
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. |
| doi_str_mv | 10.1371/journal.pone.0150285 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_1771271291</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A444363837</galeid><doaj_id>oai_doaj_org_article_165875ea51ef4e32a3061ffdc8553bb5</doaj_id><sourcerecordid>A444363837</sourcerecordid><originalsourceid>FETCH-LOGICAL-c692t-77925eccb44f13cf95d29a7c4709cd6da0cd2a74e54979a396d3538421d4e76e3</originalsourceid><addsrcrecordid>eNqNk99u0zAUxiMEYmPwBggsISG4aInjfzUXSKViUGlTp3Vwa7nOSeopjUvsdOvT8Ko4aza1aBcokWKd_M53fD77JMlrnA4xEfjTtWubWlfDtathmGKWZiP2JDnGkmQDnqXk6d76KHnh_XWaMjLi_HlylHGJJRvJ4-TP1RLQKWhvF7ayYYt0naNZbVzlSmt0hea6gBh2BRrf2qrSzRZdwgYaD-hcr9e2LpGt0YUOFurg0Y0NS_S1iYIBTXRtoPmMxmi-9QFWkTFdsoWbuzLnEPRgHHvYeuu7CheN82swwW4AzUObW_Avk2eFrjy86r8nyc_Tb1eTH4Oz2ffpZHw2MFxmYSCEzBgYs6C0wMQUkuWZ1MJQkUqT81ynJs-0oMCoFFITyXMSzaAZzikIDuQkebvTXVfOq95br7AQOIuvxJGY7ojc6Wu1buwqeqGctuou4JpS6SZ2WIHCnI0EA80wFBRIpknKcVHkZsQYWSxY1PrSV2sXK8hNtK7R1YHo4Z_aLlXpNoqKeHKERIEPvUDjfrfgg1pZbyCeTw2u7fbNJc_i1jv03T_o4931VKljA7YuXKxrOlE1ppQSTkZERGr4CBWfHFbWxItY2Bg_SPh4kBCZALeh1K33ajq__H929uuQfb_HLkFXYeld1Qbran8I0h1o4t3yDRQPJuNUdXN074bq5kj1cxTT3uwf0EPS_eCQv6rrGWw</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1771271291</pqid></control><display><type>article</type><title>The Feasibility and Oncological Safety of Axillary Reverse Mapping in Patients with Breast Cancer: A Systematic Review and Meta-Analysis of Prospective Studies</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Public Library of Science (PLoS)</source><source>PubMed Central</source><source>Free Full-Text Journals in Chemistry</source><creator>Han, Chao ; Yang, Ben ; Zuo, Wen-Shu ; Zheng, Gang ; Yang, Li ; Zheng, Mei-Zhu</creator><contributor>Liu, Xiaoan</contributor><creatorcontrib>Han, Chao ; Yang, Ben ; Zuo, Wen-Shu ; Zheng, Gang ; Yang, Li ; Zheng, Mei-Zhu ; Liu, Xiaoan</creatorcontrib><description>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.
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.
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.
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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0150285</identifier><identifier>PMID: 26919589</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Analysis ; Arm - anatomy & histology ; Axilla ; Biology and Life Sciences ; Biopsy ; Breast cancer ; Breast Neoplasms - pathology ; Cancer ; Cancer patients ; Cancer therapies ; Care and treatment ; Coloring Agents - administration & dosage ; Complications ; Complications and side effects ; Dissection ; Feasibility Studies ; Female ; Health aspects ; Hospitals ; Humans ; Identification ; Incidence ; Injections, Intradermal ; Libraries ; Lymph ; Lymph node biopsy ; Lymph Node Excision - adverse effects ; Lymph Node Excision - methods ; Lymph nodes ; Lymph Nodes - pathology ; Lymphatic drainage ; Lymphatic Metastasis ; Lymphatic system ; Lymphatic System - anatomy & histology ; Lymphatic Vessels - anatomy & histology ; Lymphedema ; Lymphedema - etiology ; Lymphedema - prevention & control ; Mapping ; Medicine and Health Sciences ; Meta-analysis ; Metastases ; Metastasis ; Oncology ; Patients ; Physical Sciences ; Physicians ; Preoperative Care ; Prospective Studies ; Research and Analysis Methods ; Safety ; Safety and security measures ; Sentinel Lymph Node Biopsy - adverse effects ; Studies ; Surgery ; Surgical outcomes</subject><ispartof>PloS one, 2016-02, Vol.11 (2), p.e0150285-e0150285</ispartof><rights>COPYRIGHT 2016 Public Library of Science</rights><rights>2016 Han et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2016 Han et al 2016 Han et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-77925eccb44f13cf95d29a7c4709cd6da0cd2a74e54979a396d3538421d4e76e3</citedby><cites>FETCH-LOGICAL-c692t-77925eccb44f13cf95d29a7c4709cd6da0cd2a74e54979a396d3538421d4e76e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4769133/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4769133/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2100,2926,23865,27923,27924,53790,53792,79371,79372</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26919589$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Liu, Xiaoan</contributor><creatorcontrib>Han, Chao</creatorcontrib><creatorcontrib>Yang, Ben</creatorcontrib><creatorcontrib>Zuo, Wen-Shu</creatorcontrib><creatorcontrib>Zheng, Gang</creatorcontrib><creatorcontrib>Yang, Li</creatorcontrib><creatorcontrib>Zheng, Mei-Zhu</creatorcontrib><title>The Feasibility and Oncological Safety of Axillary Reverse Mapping in Patients with Breast Cancer: A Systematic Review and Meta-Analysis of Prospective Studies</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>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.
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.
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.
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.</description><subject>Analysis</subject><subject>Arm - anatomy & histology</subject><subject>Axilla</subject><subject>Biology and Life Sciences</subject><subject>Biopsy</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - pathology</subject><subject>Cancer</subject><subject>Cancer patients</subject><subject>Cancer therapies</subject><subject>Care and treatment</subject><subject>Coloring Agents - administration & dosage</subject><subject>Complications</subject><subject>Complications and side effects</subject><subject>Dissection</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Health aspects</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Identification</subject><subject>Incidence</subject><subject>Injections, Intradermal</subject><subject>Libraries</subject><subject>Lymph</subject><subject>Lymph node biopsy</subject><subject>Lymph Node Excision - adverse effects</subject><subject>Lymph Node Excision - methods</subject><subject>Lymph nodes</subject><subject>Lymph Nodes - pathology</subject><subject>Lymphatic drainage</subject><subject>Lymphatic Metastasis</subject><subject>Lymphatic system</subject><subject>Lymphatic System - anatomy & histology</subject><subject>Lymphatic Vessels - anatomy & histology</subject><subject>Lymphedema</subject><subject>Lymphedema - etiology</subject><subject>Lymphedema - prevention & control</subject><subject>Mapping</subject><subject>Medicine and Health Sciences</subject><subject>Meta-analysis</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Oncology</subject><subject>Patients</subject><subject>Physical Sciences</subject><subject>Physicians</subject><subject>Preoperative Care</subject><subject>Prospective Studies</subject><subject>Research and Analysis Methods</subject><subject>Safety</subject><subject>Safety and security measures</subject><subject>Sentinel Lymph Node Biopsy - adverse effects</subject><subject>Studies</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk99u0zAUxiMEYmPwBggsISG4aInjfzUXSKViUGlTp3Vwa7nOSeopjUvsdOvT8Ko4aza1aBcokWKd_M53fD77JMlrnA4xEfjTtWubWlfDtathmGKWZiP2JDnGkmQDnqXk6d76KHnh_XWaMjLi_HlylHGJJRvJ4-TP1RLQKWhvF7ayYYt0naNZbVzlSmt0hea6gBh2BRrf2qrSzRZdwgYaD-hcr9e2LpGt0YUOFurg0Y0NS_S1iYIBTXRtoPmMxmi-9QFWkTFdsoWbuzLnEPRgHHvYeuu7CheN82swwW4AzUObW_Avk2eFrjy86r8nyc_Tb1eTH4Oz2ffpZHw2MFxmYSCEzBgYs6C0wMQUkuWZ1MJQkUqT81ynJs-0oMCoFFITyXMSzaAZzikIDuQkebvTXVfOq95br7AQOIuvxJGY7ojc6Wu1buwqeqGctuou4JpS6SZ2WIHCnI0EA80wFBRIpknKcVHkZsQYWSxY1PrSV2sXK8hNtK7R1YHo4Z_aLlXpNoqKeHKERIEPvUDjfrfgg1pZbyCeTw2u7fbNJc_i1jv03T_o4931VKljA7YuXKxrOlE1ppQSTkZERGr4CBWfHFbWxItY2Bg_SPh4kBCZALeh1K33ajq__H929uuQfb_HLkFXYeld1Qbran8I0h1o4t3yDRQPJuNUdXN074bq5kj1cxTT3uwf0EPS_eCQv6rrGWw</recordid><startdate>20160226</startdate><enddate>20160226</enddate><creator>Han, Chao</creator><creator>Yang, Ben</creator><creator>Zuo, Wen-Shu</creator><creator>Zheng, Gang</creator><creator>Yang, Li</creator><creator>Zheng, Mei-Zhu</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20160226</creationdate><title>The Feasibility and Oncological Safety of Axillary Reverse Mapping in Patients with Breast Cancer: A Systematic Review and Meta-Analysis of Prospective Studies</title><author>Han, Chao ; Yang, Ben ; Zuo, Wen-Shu ; Zheng, Gang ; Yang, Li ; Zheng, Mei-Zhu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-77925eccb44f13cf95d29a7c4709cd6da0cd2a74e54979a396d3538421d4e76e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Analysis</topic><topic>Arm - anatomy & histology</topic><topic>Axilla</topic><topic>Biology and Life Sciences</topic><topic>Biopsy</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - pathology</topic><topic>Cancer</topic><topic>Cancer patients</topic><topic>Cancer therapies</topic><topic>Care and treatment</topic><topic>Coloring Agents - administration & dosage</topic><topic>Complications</topic><topic>Complications and side effects</topic><topic>Dissection</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Health aspects</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Identification</topic><topic>Incidence</topic><topic>Injections, Intradermal</topic><topic>Libraries</topic><topic>Lymph</topic><topic>Lymph node biopsy</topic><topic>Lymph Node Excision - adverse effects</topic><topic>Lymph Node Excision - methods</topic><topic>Lymph nodes</topic><topic>Lymph Nodes - pathology</topic><topic>Lymphatic drainage</topic><topic>Lymphatic Metastasis</topic><topic>Lymphatic system</topic><topic>Lymphatic System - anatomy & histology</topic><topic>Lymphatic Vessels - anatomy & histology</topic><topic>Lymphedema</topic><topic>Lymphedema - etiology</topic><topic>Lymphedema - prevention & control</topic><topic>Mapping</topic><topic>Medicine and Health Sciences</topic><topic>Meta-analysis</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Oncology</topic><topic>Patients</topic><topic>Physical Sciences</topic><topic>Physicians</topic><topic>Preoperative Care</topic><topic>Prospective Studies</topic><topic>Research and Analysis Methods</topic><topic>Safety</topic><topic>Safety and security measures</topic><topic>Sentinel Lymph Node Biopsy - adverse effects</topic><topic>Studies</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Han, Chao</creatorcontrib><creatorcontrib>Yang, Ben</creatorcontrib><creatorcontrib>Zuo, Wen-Shu</creatorcontrib><creatorcontrib>Zheng, Gang</creatorcontrib><creatorcontrib>Yang, Li</creatorcontrib><creatorcontrib>Zheng, Mei-Zhu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Han, Chao</au><au>Yang, Ben</au><au>Zuo, Wen-Shu</au><au>Zheng, Gang</au><au>Yang, Li</au><au>Zheng, Mei-Zhu</au><au>Liu, Xiaoan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Feasibility and Oncological Safety of Axillary Reverse Mapping in Patients with Breast Cancer: A Systematic Review and Meta-Analysis of Prospective Studies</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2016-02-26</date><risdate>2016</risdate><volume>11</volume><issue>2</issue><spage>e0150285</spage><epage>e0150285</epage><pages>e0150285-e0150285</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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.
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.
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.
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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>26919589</pmid><doi>10.1371/journal.pone.0150285</doi><oa>free_for_read</oa></addata></record> |
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| language | eng |
| recordid | cdi_plos_journals_1771271291 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Analysis Arm - anatomy & histology Axilla Biology and Life Sciences Biopsy Breast cancer Breast Neoplasms - pathology Cancer Cancer patients Cancer therapies Care and treatment Coloring Agents - administration & dosage Complications Complications and side effects Dissection Feasibility Studies Female Health aspects Hospitals Humans Identification Incidence Injections, Intradermal Libraries Lymph Lymph node biopsy Lymph Node Excision - adverse effects Lymph Node Excision - methods Lymph nodes Lymph Nodes - pathology Lymphatic drainage Lymphatic Metastasis Lymphatic system Lymphatic System - anatomy & histology Lymphatic Vessels - anatomy & histology Lymphedema Lymphedema - etiology Lymphedema - prevention & control Mapping Medicine and Health Sciences Meta-analysis Metastases Metastasis Oncology Patients Physical Sciences Physicians Preoperative Care Prospective Studies Research and Analysis Methods Safety Safety and security measures Sentinel Lymph Node Biopsy - adverse effects Studies Surgery Surgical outcomes |
| title | The Feasibility and Oncological Safety of Axillary Reverse Mapping in Patients with Breast Cancer: A Systematic Review and Meta-Analysis of Prospective Studies |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-12T06%3A37%3A40IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20Feasibility%20and%20Oncological%20Safety%20of%20Axillary%20Reverse%20Mapping%20in%20Patients%20with%20Breast%20Cancer:%20A%20Systematic%20Review%20and%20Meta-Analysis%20of%20Prospective%20Studies&rft.jtitle=PloS%20one&rft.au=Han,%20Chao&rft.date=2016-02-26&rft.volume=11&rft.issue=2&rft.spage=e0150285&rft.epage=e0150285&rft.pages=e0150285-e0150285&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0150285&rft_dat=%3Cgale_plos_%3EA444363837%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1771271291&rft_id=info:pmid/26919589&rft_galeid=A444363837&rft_doaj_id=oai_doaj_org_article_165875ea51ef4e32a3061ffdc8553bb5&rfr_iscdi=true |