ARM: Axillary Reverse Mapping
Each patient will receive an injection of 1.0 mCi of technetium-99m sulfur colloid into the
normal breast tissue surrounding the primary cancer or biopsy cavity directed subareolar or
around the tumor.
If the radioactive SLN cannot be located prior to incision via gamma probe then the blue dye
will be used in the breast either in the subareolar plexus or peritumorally at the
discretion of the surgeon. For this contingency (expected to occur <3% of the time), the
blue dye will be used in the breast (and NOT the arm), as the prime concern is locating the
SLN for staging.
If the blue dye is unnecessary to find the sentinel node draining from the breast, then it
will be injected dermally in the upper inner arm along the Biceps groove of the ipsilateral
arm in order to locate the draining lymphatics from the arm. No more than 5cc of blue dye
will be injected in either the subareolar plexus, peritumorally (intraparenchymal or
dermally), or dermally in the patient's ipsilateral arm dependent upon the contingencies
stated above. Site of all injections (radioactivity and/or blue dye) will be recorded.
Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Prevention
Occurrence of lymphedema by the first year following surgery
V. Suzanne Klimberg, MD
University of Arkansas
United States: Institutional Review Board
|University of Arkansas for Medical Sciences||Little Rock, Arkansas 72205|