ABSTRACT
Background
This is a systematic review of randomized controlled trials (RCT) comparing the use
of axillary reverse mapping (ARM) with conventional technique for axillary dissection
(AD) in breast cancer surgery.
Methods
This review was written in line with the PRISMA protocol. Articles were retrieved
from PubMed, EMBASE, CINAHL and Cochrane databases, using keywords ..úaxillary reverse
mapping..Ñ and “axillary lymph node dissection”. Non-RCT were excluded. Abstracts
were screened independently by 2 reviewers. Data from eligible studies were retrieved
for qualitative synthesis and pooled analysis. 73 publications were identified for
initial screening.
Results
68 articles were excluded from analysis according to the pre-defined systematic review
protocol. 5 RCTS with 1696 subjects were included for analysis. 802 patients received
ARM, 894 patients received AD. Pooled ARM node detection rate was 84.9% (Range 79.2
- 94.9%). There was a lower rate of post-operative lymphedema in ARM group patients
across all 5 RCTs. The pooled lymphedema incidence in the ARM group was 4.8% (37/766)
when compared to 18.8% (164/873) in the AD group (P < .0001). Axillary recurrence rate with median followof 37 months was 1.03% (8/778)
in the ARM group, which was identical to 1.03% (9/870) in the AD group (P = 1).
Conclusion
ARM resulted in decreased incidence of lymphedema. There was no significant increase
in axillary recurrence at 37 months post-operation.
Keywords
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Article info
Publication history
Published online: October 19, 2022
Accepted:
October 13,
2022
Received in revised form:
October 6,
2022
Received:
August 23,
2022
Footnotes
M.C. and L.L. are contributed equally to this work as first authors.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
