FEASIBILITY OF AXILLARY REVERSE MAPPING USING LOW-COST FLUORESCEIN DYE AND METHYLENE BLUE DYE garvitgarg365@gmail.com

425-05

FEASIBILITY OF AXILLARY REVERSE MAPPING USING LOW-COST FLUORESCEIN DYE AND METHYLENE BLUE DYE

2

India

Oral or Poster

Axillary Reverse Mapping (ARM) is a technique aimed at preserving the lymphatic drainage of the arm during axillary lymph node dissection, thereby reducing the risk of lymphedema in breast cancer surgery. High-cost dyes and advanced imaging technologies often limit its widespread adoption, especially in resource-limited settings. This study explores the feasibility and safetyof using low-cost Fluorescein and Methylene Blue dyes for ARM.

A Randomised control trial was conducted involving breast cancer patients undergoing axillary lymph node dissection. Fluorescein dye and Methylene Blue dye were injected intraoperatively into the arm and breast, respectively, to delineate lymphatic pathways. The visualization rates, identification of ARM lymphatics, crossover rates between breast and arm lymphatics, and associated complications were assessed.

Fluorescein dye successfully delineated arm lymphatics in 80% of cases under blue light, while Methylene Blue dye visualized axillary lymphatics in 90% of cases. Crossover of lymphatic pathways was noted in 10% of patients, aiding in strategic node preservation. No significant complications such as allergic reactions or staining were observed. The combined use of Fluorescein and Methylene Blue proved highly cost-effective, with expenses significantly lower than conventional techniques.

The use of low-cost Fluorescein and Methylene Blue dyes for ARM is a feasible and safe alternative in resource-constrained settings. This technique can facilitate broader implementation of ARM, potentially improving patient outcomes by reducing lymphedema risks without substantial financial burden.