Clinical application of axillary reverse mapping in patients with breast cancer: A systematic review and meta-analysis

Background The axillary reverse mapping (ARM) technique, identify and preserve arm nodes during sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND), was developed to prevent breast-cancer related lymphedema (BCRL) remains controversial. Methods A comprehensive search of Medline Ovid, Pubmed, Web of Science and the Cochrane CENTRAL databases was conducted from the inception till January 2020. The key word including “breast cancer”, “axillary reverse mapping”, and “lymphedema”. Stata 15.1 software was used for the meta-analysis. Results As a result, twenty-nine related studies involving 4954 patients met our inclusion criteria. The pooled overall estimate lymphedema incidence was 7% (95% CI 4%–11%, I2 = 90.35%, P
Highlights • ARM is a simple and feasible technique that effectively reduces the incidence of BCRL. • Performing ARM technique for breast cancer patients should be considered carefully on account of its oncological safety. • Preoperative NAC is not correlated with less metastatic involvement in the ARM lymph nodes.