Gobardhan Paul D, Klompenhouwer Elisabeth G, Beek Martinus A, Voogd Adri C, Luiten Ernest J T
Amphia Ziekenhuis, afd. Chirurgie, Breda.
Ned Tijdschr Geneeskd. 2013;157(22):A5646.
A considerable percentage of breast cancer patients who have undergone an axillary lymph node dissection (ALND) experience postoperative complications, with lymphoedema occurring most frequently. Axillary Reverse Mapping (ARM) is a new technique in which the lymphatic drainage system of the upper extremity can be visualized during an ALND. If lymphoedema is caused by severing of the lymphatic drainage system or removal of its associated lymph nodes, the preservation of these structures should reduce the incidence of lymphoedema. Patients who might benefit from ARM are patients for whom a subsequent ALND is indicated following a positive sentinel lymph node diagnostic procedure, and perhaps also patients who have an indication for a primary ALND following neo-adjuvant chemotherapy. A multicenter RCT is to start in the near future, during which we will investigate whether the preservation of axillary lymph nodes results in reduced morbidity.
相当比例接受腋窝淋巴结清扫术（ALND）的乳腺癌患者会出现术后并发症，其中淋巴水肿最为常见。腋窝反向映射（ARM）是一种新技术，在ALND过程中可以可视化上肢的淋巴引流系统。如果淋巴水肿是由淋巴引流系统切断或其相关淋巴结切除引起的，保留这些结构应能降低淋巴水肿的发生率。可能从ARM中受益的患者是那些在前哨淋巴结诊断程序呈阳性后需要进行后续ALND的患者，也许还包括那些在新辅助化疗后有原发性ALND指征的患者。一项多中心随机对照试验将在不久的将来启动，在此期间我们将研究保留腋窝淋巴结是否会降低发病率。
