Reverse Axillary Mapping

Reverse Axillary Mapping is a brilliant idea (in a string of brilliant ideas) from Dr. Suzanne Klimberg - a professor of surgery at the University of Arkansas in Little Rock. In addition to mapping the breast to find the sentinel nodes that drain the breast, she thought 'Why don't we map the arm lymphatics at the same time and avoid injuring them?' This decreases the chance of getting lymphedema of the arm (swelling caused by extra fluid in the arm because the outflow has been disturbed). In her series of patients, she has a very low incidence of arm swelling.

The technique involves injecting a small amount of blue dye in the upper inner aspect of the arm. The blue lymphatics that drain the arm can then be identified and avoided at the time of sentinel lymph node biopsy (unless clinically full of cancer). The breast sentinel nodes are identified by injecting the breast with a radioactive dye that drains and makes the sentinel nodes slightly radioactive. These radioactive lymph nodes are identified with a gamma radiation detector and removed at the time of surgery. Reverse Axillary Mapping is a brilliant idea (in a string of brilliant ideas) from Dr. Suzanne Klimberg - a professor of surgery at the University of Arkansas in Little Rock. In addition to mapping the breast to find the sentinel nodes that drain the breast, she thought 'Why don't we map the arm lymphatics at the same time and avoid injuring them?' This decreases the chance of getting lymphedema of the arm (swelling caused by extra fluid in the arm because the outflow has been disturbed). In her series of patients, she has a very low incidence of arm swelling.

The technique involves injecting a small amount of blue dye in the upper inner aspect of the arm. The blue lymphatics that drain the arm can then be identified and avoided at the time of sentinel lymph node biopsy (unless clinically full of cancer). The breast sentinel nodes are identified by injecting the breast with a radioactive dye that drains and makes the sentinel nodes slightly radioactive. These radioactive lymph nodes are identified with a gamma radiation detector and removed at the time of surgery.