title: Lymphatic mapping and sentinel node biopsy in women with an ipsilateral second breast carcinoma and a history of breast and axillary surgery.
abstract: BACKGROUND
  Women with a history of breast and axillary surgery may demonstrate aberrant lymphatic drainage caused by disrupted lymphatic channels. Lymphoscintigraphy may be valuable in evaluation and staging of an ipsilateral second breast carcinoma.
  
  
  METHODS
  We conducted a retrospective review of 16 women treated for a second ipsilateral breast carcinoma who underwent breast lymphoscintigraphy and intraoperative lymphatic mapping. Drainage patterns were compared with pathologic and operative findings.
  
  
  RESULTS
  Lymphoscintigraphy succeeded in 69% of patients and demonstrated widely varied drainage patterns including ipsilateral axillary and supraclavicular as well as contralateral axillary and supraclavicular basins. No trend between successful lymphatic mapping and multiple clinical and pathologic measures was seen.
  
  
  CONCLUSIONS
  In women with a second ipsilateral breast carcinoma and history of previous breast and axillary surgery, lymphoscintigraphy is feasible. Drainage patterns vary widely including across the midline of the thorax. Preoperative lymphoscintigraphy may be useful to ensure inclusion of potential sentinel nodes within the operative field.
authors.affiliation: Department of Radiology, Second Floor, William Beaumont Hospital, 3601 W. 13 Mile Rd., Royal Oak, MI 48073, USA. ddinan@beaumont.edu
authors.forename: David
authors.initials: D
authors.lastname: Dinan
authors.forename: Conrad E
authors.initials: CE
authors.lastname: Nagle
authors.forename: Jane
authors.initials: J
authors.lastname: Pettinga
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla / Q000473:pathology / Q000601:surgery*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000473:pathology*; D011877:Radionuclide Imaging / Q000379:methods*; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy