The Clinical Feasibility And Oncological Safety Of Axillary Reverse Mapping In Breast Cancer:A Meta-analysis

Objective To evaluate the clinical feasibility and oncological safety of axillary reverse mapping in breast cancer.Methods Systematic retrieval of PubMed,Embase,Cochrane library and CNKI,WanFang and Vip databases on the use of axillary reverse mapping in breast cancer axillary surgery was performed during Aug.1 2009 to Aug.1 2019.According to include and exclude standards in the study for the rate of upper limb lymphedema,Lymph node identification rate,Arm crossover rate,Upper lymph node metastasis rate using Stata 15.0 software for Meta analysis.Results A total of 24 studies,including 3 651 patients,including 5 randomized controlled trial studies and 19 prospective cohort studies.Meta analysis results of single group rates showed that in axillary reverse mapping(ARM),the incidence of upper limb lymphedema in axillary lymph node dissection(ALND)was 5%(95% CI 3%-7%),and the incidence of upper limb lymphedema in sentinel lymph node biopsy(SLNB)was 1%(95%CI 1%-2%).The SLNB lymph node/lymphatic identification rate was 44%(95%CI 34%-54%),the ALND lymph node/lymphatic identification rate was 83%(95%CI 78%-88%),and the sentinel lymph node-axillary reverse mapping crossover rate was 6%(95%CI 4%-7%).The lymph node metastasis rate was 18%(95%CI 13%-23%).Conclusion Axillary reverse mapping can significantly reduce breast cancer-related lymphedema,but there is a risk of upper limb lymph node metastasis.