Mostafa Abd-Eltawab Sakkary, Osama Malt, M Khafagy, M Shaalan and Alaadin Hussien
Cairo University, Egypt
Posters-Accepted Abstracts: Surgery Curr Res
The most long-term and devastating morbidity of surgery for breast cancer is lymphedema of the arm, even in patients undergoing SLNB (7-13%). Lymphatic ArmMapping (LAM) is a new technique to map the drainage of the arm with blue dye decreases the likelihood of disruption of lymphatics and subsequent lymphedema. This was a prospective study that was conducted on 75 patients, at the National Cancer Institute, Cairo University, Egypt, with early breast cancer, requiring an axillary dissection undergoing either modified radical mastectomy (MRM) or breast conservative surgery (BCS). Blue dye was injected sub-dermally in the upper arm with an attempt to identify and separately excise specific lymph nodes related to and draining the arm from nodes draining the breast. The identified blue nodes and ducts were separately removed and sent for pathological evaluation. Axillary dissection is then completed. Lymphatic arm mapping (LAM), also known as Axillary Reversed Mapping was identified in 65 patients with identification rate of 86.6%. The sentinel node of the upper limb was found mainly lateral to the thoraco-dorsal vessels. In 9 patients with cross over between breast and arm nodes, metastases were found in 5 patients (i.e. 55.5%). In conclusion, LAM is safe as a concept especially in early breast cancer. If axillary nodes are clinically positive and when cross over is suspected, these nodes should also be removed during axillary dissection as they have high incidence of metastasis. LAM is most beneficial as complementary to SLNB and further research on LAM is warranted.
Mostafa Abd-Eltawab Sakkary is an Assistant Professor, completed his MD in Surgical Oncology from the National Cancer Institute, Cairo University. He has published more than 10 papers in both national and international reputed journals, most of them in the field of breast cancer surgery. He has participated in many national and international cancer conferences as a poster presenter and as a speaker.
