Axillary reverse mapping (ARM) as a means to reduce lymphedema during sentinel lymph node or axillary node dissection

Our group has hypothesized that variations in the anatomical location of the arm lymphatic drainage system within the axilla put the arm lymphatics at risk for disruption during an SLNB and/or ALND. Therefore, mapping and protecting the drainage of the arm versus that of the breast within the axilla by split mapping using blue dye to identify and protect the lymphatics draining from the arm (axillary reverse mapping (ARM)) and radioactivity to map those draining from the breast would decrease the likelihood of inadvertent disruption during lymphadenectomy. Mapping and sparing the lymphatics draining the arm during SLNB or ALND decrease the subsequent development of lymphedema as compared to SLN mapping alone.