Impact of the ARM Technique on the Prevention of Lymphedema After Axillary Lymphadenectomy: A Multicenter Randomized Clinical Trial

Inclusion Criteria: Breast cancer patients with an indication for axillary lymphadenectomy according to the multidisciplinary team: * cN0 with positive sentinel lymph node biopsy (pN+) requiring axillary lymphadenectomy: cT3; More than two axillary macrometastases; or patients undergoing mastectomy without indication for adjuvant radiotherapy * cN1: Primary surgery; or after neoadjuvant therapy without complete axillary response and/or positive TAD (ypN+) * cN2: Primary surgery; or after neoadjuvant therapy in luminal tumors and/or without complete axillary response in triple-negative or HER2-positive tumors, and/or positive TAD (ypN+) Exclusion Criteria: * Patients with prior axillary radiotherapy * Patients with suspected metastatic involvement based on palpation of ARM lymph nodes during the surgical procedure * Patients participating in other studies whose primary objective depends on local axillary treatment * Patients unwilling to participate in the study