{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T21:57:09Z","timestamp":1791496629464,"version":"4.3.4"},"reference-count":26,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T00:00:00Z","timestamp":1781308800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T00:00:00Z","timestamp":1781308800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with locally advanced breast cancer (LABC) undergoing axillary lymph node dissection (ALND) after neoadjuvant chemotherapy (NACT) face substantial risk of arm morbidity and lymphedema. Axillary reverse mapping (ARM) may preserve upper\u2010limb lymphatic drainage; however, evidence in post\u2010NACT LABC particularly from resource\u2010constrained settings is limited. This phase I study evaluated the feasibility of a low\u2010cost dual\u2010dye ARM and its impact on arm\u2010related quality of life using LYMPH\u2010Q.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective study, 32 patients with LABC undergoing axillary surgery after NACT were included: 16 underwent standard ALND and 16 underwent ALND with ARM. ARM was performed using fluorescein sodium injected into the ipsilateral first web space and methylene blue injected subareolarly. ARM structures were preserved when oncologically safe. LYMPH\u2010Q Upper Extremity scores were assessed at baseline, 6\u00a0months, and 12\u00a0months. Arm circumference and lymphedema incidence were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline clinico\u2010pathologic characteristics were comparable between groups. ARM did not significantly increase operative time (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.166) or compromise nodal yield (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.239). Fluorescent lymphatic channels were identified and preserved in 15\/16 ARM cases. At 12\u00a0months, LYMPH\u2010Q Symptoms scores were significantly higher in the ARM group (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.039), with greater improvement from baseline\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.017). Lymphedema incidence was lower with ARM, though not statistically significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.600). Increases in mid\u2010upper arm and forearm circumference were significantly lower.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Low\u2010cost dual\u2010dye ARM is feasible following NACT in LABC and may improve patient\u2010reported arm symptoms while maintaining comparable operative and pathological outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70462","type":"journal-article","created":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T08:07:43Z","timestamp":1781338063000},"page":"2207-2213","source":"Crossref","is-referenced-by-count":1,"title":["Low\u2010Cost Dual\u2010Dye Axillary Reverse Mapping in Locally Advanced Breast Cancer After Neoadjuvant Chemotherapy: A Phase I Feasibility and Arm\u2010Related Quality of Life Outcomes Study"],"prefix":"10.1002","volume":"50","author":[{"given":"Garvit","family":"Garg","sequence":"first","affiliation":[{"name":"Department of Surgery NSCB Medical College  Jabalpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arvind","family":"Baghel","sequence":"additional","affiliation":[{"name":"Department of Surgery NSCB Medical College  Jabalpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0682-4970","authenticated-orcid":false,"given":"Sanjay Kumar","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Surgery NSCB Medical College  Jabalpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0604-8676","authenticated-orcid":false,"given":"Dhananjaya","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Surgery NSCB Medical College  Jabalpur 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