[Preoperative lymphoscintigraphy to identify the sentinel lymph node in breast cancer].
BACKGROUND
The preoperative lymphoscintigraphy to the Sentinel Node Biopsy (SNB) can reproduce the lymphatic drainage of the tumour in breast cancer.


OBJECTIVE
To establish the pattern of lymphatic drainage of the mammary tumors by means of isotopic lymphoscintigraphy and determine the factors that could influence the negativity of the scintigraphy.


METHODS
121 patients with breast cancer who were going to undergo mammary surgery were studied with SNB. One day before the operation, 37 MBq 99mTc-colloidal sulphide colloid in a volume of 2 ml was injected in peritumoral tissue. Mammary lymphoscintigraphies were performed at 30 minutes and 18 hours P.I., in ANT and OA projections of the corresponding chest. After, the clinical-biological parameters and their influence on the result of the lymphoscintigraphy were analyzed.


RESULTS
The scintigraphy were positive in 85 % of the patients. The axillary chain was observed in 97 % and the internal mammary chain in 11 %. The factors associated to the absence of visualization of the sentinel node were: older than 50 years (94 %), menopause (89 %), tumoral size > or = 2 cm (67 %), axillary metastases (67 %), the overexpression of C-erbB-2 oncoprotein (44 %) and proliferative activity > 10 % (67 %).


CONCLUSIONS
The peritumoral injection of the radiocolloid establishes the lymphatic drainage pattern in the patients with breast cancer. Its absence of visualization can be associated to circumstances like: age > or = 50 years, menopause, tumoral size > or = 2 cm, axillary metastases, tumoral overexpression of the C-erbB-2 oncoprotein and high proliferative activity of the mammary tumor.
Servicio de Medicina Nuclear. Fundación Jiménez Díaz. Madrid. Spain.
M C
MC
Resino
C
C
Sánchez Hermosa
G
G
Lapeña
C
C
Pardo
A
A
Ruibal
C
C
Medina
J M
JM
San Román
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging*; D061305:Lymphoscintigraphy; D008875:Middle Aged; D011300:Preoperative Care; D019275:Radiopharmaceuticals; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013671:Technetium Tc 99m Sulfur Colloid
D019275:Radiopharmaceuticals; D013671:Technetium Tc 99m Sulfur Colloid