Lymphatic mapping in patients with breast carcinoma: reproducibility of lymphoscintigraphic results.
OBJECTIVE
To evaluate the reproducibility of lymphoscintigraphic results in assessment of the location and number of sentinel nodes in patients with breast cancer.


METHODS
Twenty-five patients with breast cancer were prospectively enrolled in this study. Lymphoscintigraphy was performed after intratumoral injection of about 130 MBq of technetium 99m nanocolloid. Anterior and lateral images were obtained 20 minutes and 2 and 4 hours after injection. The following day, scintigraphy was repeated after a second injection of the radiolabeled colloid in an identical fashion and was preceded by acquisition of a starting image. Two observers evaluated the paired images independently, and count rates were calculated from the images. Correlation coefficient and Bland-Altman methods were used to analyze the paired count rates.


RESULTS
At least one sentinel node was visualized at lymphoscintigraphy in all 25 patients. Drainage to the axilla was observed in 17 patients; drainage to the axilla and extraaxillary basins, in seven patients; and drainage exclusively to extraaxillary sentinel nodes, in one patient. The second scintigraphic study revealed the same drainage pattern in all 25 patients (reproducibility, 100%; 95% CI: 86%, 100%). The Pearson correlation coefficient of the paired count rates was 0.54 (P <.001). Count rates at repeat scintigraphy were 23%-417% of the count rates at first scintigraphy in 95% of cases.


CONCLUSIONS
Results of lymphoscintigraphy for lymphatic mapping in breast cancer are highly reproducible for assessment of the number of sentinel nodes.
Tanis
Pieter J
PJ
Departments of Surgery and Nuclear Medicine, Netherlands Cancer Institute, Amsterdam. e.p.tanis@slaz.nl
Valdés Olmos
Renato A
RA
Muller
Saar H
SH
Nieweg
Omgo E
OE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging*; D008875:Middle Aged; D011446:Prospective Studies; D011877:Radionuclide Imaging; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy; D013668:Technetium Tc 99m Aggregated Albumin
D003287:Contrast Media; D013668:Technetium Tc 99m Aggregated Albumin; C083602:technetium Tc 99m nanocolloid