Sentinel node biopsy and internal mammary lymphatic mapping in breast cancer.
BACKGROUND
Currently outer quadrant breast tumors are not felt to have significant drainage to the internal mammary nodal chain. We evaluated the incidence of internal mammary sentinel nodes (IMSN) found with lymphoscintigraphy for all breast quadrants.


METHODS
Eighty women were prospectively studied by technitium-sulfur colloid injection, nuclear medicine imaging, and intraoperative gamma probe identification of sentinel nodes. IMSN detected were surgically removed.


RESULTS
Ten of 80 ( 12%) patients had IMSN identified in addition to axillary sentinel nodes (AXSN). Four tumors were located medially, 6 (60%) were in the outer quadrants. Metastatic disease was present in 3 of 10 women. Patients with positive IMSN also had positive AXSN.


CONCLUSIONS
Patients undergoing lymphatic mapping for the management of breast cancer should have radiolabelled tracer and gamma probe sentinel node identification regardless of tumor location in the breast.
Legacy Cancer Services, Good Samaritan Hospital, Department of Surgery, Oregon Health Sciences University, Portland, Oregon, USA.
N
N
Johnson
L
L
Soot
J
J
Nelson
M D
MD
Franzini
H
H
Vea
S
S
Gruner
L
L
Kulawiak
K
K
Young
D001706:Biopsy / Q000379:methods*; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D015902:Gamma Cameras; D006801:Humans; D015994:Incidence; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging* / Q000473:pathology*; D008323:Mammary Arteries; D016343:Monitoring, Intraoperative / Q000379:methods*; D009367:Neoplasm Staging / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011877:Radionuclide Imaging; D015203:Reproducibility of Results; D013671:Technetium Tc 99m Sulfur Colloid; D018084:Ultrasonography, Interventional / Q000379:methods*
D013671:Technetium Tc 99m Sulfur Colloid