Preoperative lymphoscintigraphy and internal mammary sentinel lymph node biopsy do not enhance the accuracy of lymphatic mapping for breast cancer

Lawson, Laura L.; Sandler, Martin; Martin, William; Beauchamp, Daniel; Kelley, Mark C.; Beauchamp, R Daniel
December 2004
American Surgeon;Dec2004, Vol. 70 Issue 12, p1050
Academic Journal
journal article
Lymphoscintigraphy (LS) may identify sentinel lymph nodes (SLNs) outside the axilla. Biopsy of these nodes could improve the accuracy of lymphatic mapping (LM) for breast cancer (BC) if a significant number of tumor-positive extra-axillary sentinel nodes are identified. To address this, we evaluated the impact of the use of preoperative LS and biopsy of axillary and internal mammary SLNs in women with BC. From October 1997 to July 2003, 175 women with breast cancer received technetium sulfur colloid, and images were obtained. Isosulfan blue dye was injected intraoperatively, and LM of the axillary and internal mammary lymph node basins was performed with a hand-held gamma probe. The anatomic location and histologic status of all SLNs identified with LS and LM was recorded, and the impact of the findings on LS and internal mammary LM were evaluated. LS showed SLN in 127/175 (73%) women and "hot spots" were found with the gamma probe in 142/175 (81%). At least one SLN was identified by LM in 168/175 (96%) patients, and 48/168 (29%) had metastases. One hundred sixty-two of 168 (96%) patients had SLN exclusively in the axilla. Only 10 of 175 (6%) women had internal mammary (IM) SLNs seen on LS. LM identified IM sentinel nodes in 6 of these 10 patients, but none were involved with tumor. Preoperative lymphoscintigraphy and biopsy of internal mammary sentinel nodes do not enhance the accuracy of lymphatic mapping for breast cancer. Omitting lymphoscintigraphy reduces the complexity and cost of lymphatic mapping without compromising the identification of tumor-positive sentinel nodes.


Related Articles

  • Bilateral axillary and internal mammary drainage in breast cancer without prior surgery during sentinel node mapping. Vicente, Justo Serrano; Grande, M Luz Domínguez; Barquero, Carmen Durán; Torre, Jrafael Infante; Bernardo, Lucía García; Rayo Madrid, J. Ignacio; Correa Antúnez, M. Isabel // Indian Journal of Nuclear Medicine;Oct2011, Vol. 26 Issue 4, p205 

    Lymphatic drainage outside the ipsilateral axilla in breast cancer is discovered in as many as 25% of all sentinel lymph node procedures and it is evidenced by lymphoscintigraphy. Contralateral axillary drainage is a rare clinical situation, mostly if there is not prior breast surgery, but this...

  • Sentinel Lymph Node Biopsy for Breast Cancer: Our Technique and Future Directions in Lymph Node Staging. Rashid, Omar M.; Takabe, Kazuaki // Journal of Nuclear Medicine & Radiation Therapy;2012 Supplement 2, p1 

    Breast cancer remains a major cause of cancer death for women in the United States. Accurate cancer staging, especially of the axillary lymph nodes, is essential for predicting the prognosis of patients and for determining the appropriate multimodality treatment strategy. Historically, the...

  • Randomized Multicenter Trial of Sentinel Node Biopsy Versus Standard Axillary Treatment in Operable Breast Cancer: The ALMANAC Trial. Mansel, Robert E.; Fallowfield, Lesley; Kissin, Mark; Goyal, Amit; Newcombe, Robert G.; Dixon, J. Michael; Yiangou, Constantinos; Horgan, Kieran; Bundred, Nigel; Monypenny, Ian; England, David; Sibbering, Mark; Abdullah, Tholkifl I.; Barr, Lester; Chetty, Utheshtra; Sinnett, Dudley H.; Fleissig, Anne; Clarke, Dayalan; Ell, Peter J. // JNCI: Journal of the National Cancer Institute;5/3/2006, Vol. 98 Issue 9, p599 

    Background: Sentinel lymph node biopsy in women with operable breast cancer is routinely used in some countries for staging the axilla despite limited data from randomized trials on morbidity and mortality outcomes. We conducted a multicenter randomized trial to compare quality-of-life outcomes...

  • Prognostic Factors and Staging.  // Current Medical Literature: Breast Cancer;2007, Vol. 19 Issue 2, p57 

    The article discusses several studies on the prognostic factors involved in breast cancer. In a study by T. Nakagawa et, they claimed that lymph node status is the most important factor in cancer survival rate prediction. The study found that the use of sentinel lymph node biopsy (SLNB) to...

  • Drainage lymphatique du sein et des tumeurs mammaires. Kane, A.; Frey, C.; Villet, R. // Oncologie;Jun2013, Vol. 15 Issue 6, p277 

    Breast lymphatic drainage includes two systems: one superficial or cutaneous system and one deep or glandular system. The superficial one always reaches the axillary lymph nodes as does the deep one predominantly. Considering the surgical anatomy of the axilla, Berg described the levels of three...

  • Erken Evre Meme Kanserinde Sentinel Lenf Nodu Biyopsisi Sonuçlarımız. Kocakuşak, Ahmet; Şahin, Mustafa; Yaşar, Mustafa Anıl; Güler, Nurcan; Görmüş, Coşkun; Aydın, Serbülent; Özer, Ender; Pamak, Serap // Medical Bulletin of Haseki / Haseki Tip Bulteni;Jun2011, Vol. 49 Issue 2, p67 

    Aim: Sentinel lymph node biopsy (SLNB) in breast cancer patients targets the evaluation of the initial lymph node (SLN) which drains the primary tumor. The morbidity of unnecessary axillary dissection can be avoided by intensive preoperative assessment of SLN. Methods: Twenty-six consecutive...

  • Sentinel lymph node biopsy: technique validation at the Setúbal Medical Centre, Portugal. Ferreira, P.; Baía, R.; António, A.; Almeida, J.; Simões, J.; Amaro, J. C.; C.Quintana; Branco, L.; Rigueira, M. V.; Gonçalves, M.; Pereira, E. V.; Ferreira, L. M. // Ecancermedicalscience;2009, Vol. 3, p1 

    Aims: To evaluate the accuracy of sentinel lymph node biopsy in breast cancer patients at this institution, using combined technetium- 99m (99mTc) sulphur colloid and patent blue vital dye. Methods: From March 2007 to July 2008, 50 patients with a tumour of less than 3 cm and with clinically...

  • Subareolar injection of technetium-99m nanocolloid yields reliable data on the axillary lymph node tumour status in breast cancer patients with previous manipulations on the primary tumour: a prospective study of 117 patients. Maza, Sofiane; Thomas, Anke; Winzer, Klaus J.; Hüttner, Christine; Blohmer, Jens-Uwe; Hauschild, Maik; Richter, Matthias; Krössin, Thomas; Geworski, Lilli; Zander, Andreas; Guski, Hans; Munz, Dieter L. // European Journal of Nuclear Medicine & Molecular Imaging;2004, Vol. 31 Issue 5, p671 

    According to recently published guidelines, histological clarification by interventional techniques should be undertaken before planning the surgical management of patients with breast carcinoma. In patients with previous manipulations on the primary tumour, peritumoural injection in the context...

  • Clinical axillary recurrence after sentinel node biopsy in breast cancer: a follow-up study of 220 patients. Sanjuàn, A.; Vidal-Sicart, S.; Zanón, G.; Pahisa, J.; Velasco, M.; Fernández, P.L.; Santamaría, G.; Farrús, B.; Muñoz, M.; Albanell, J.; Pons, F.; Vanrell, J.A. // European Journal of Nuclear Medicine & Molecular Imaging;Aug2005, Vol. 32 Issue 8, p932 

    Purpose: The aim of this study was to evaluate the frequency of false-negative (FN) sentinel node procedures in patients with breast cancer and the subsequent clinical outcome in such patients. Methods: A total of 325 breast cancer patients underwent sentinel lymph node biopsy at our institution...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics