Effect of lymphoscintigraphy drainage patterns on sentinel lymph node biopsy in patients with breast cancer.
BACKGROUND
Sentinel lymph node (SLN) biopsy examination is an accepted method of staging breast cancer patients. SLN biopsy examination in patients with drainage to the internal mammary chain (IMC) nodes is controversial.


METHODS
A prospective study of SLN biopsy examination followed by axillary dissection was analyzed to determine how surgeons manage patients with IMC drainage and the rates of axillary SLN identification and positivity in these cases.


RESULTS
Lymphoscintigraphy was performed in 2196 (53.2%) of the 4131 patients in this study. IMC drainage was noted in 80 patients (3.6%). An axillary SLN was identified in 29 of the 40 patients with IMC drainage alone (72.5%). The rate of finding a positive axillary lymph node did not differ based on the lymphoscintigraphic pattern (P = .470).


CONCLUSIONS
Most surgeons do not perform IMC SLN biopsy procedures. Even when lymphoscintigraphy shows isolated drainage to IMC nodes, axillary SLNs usually are identified. Lymphoscintigraphy therefore has limited usefulness.
Chagpar
Anees B
AB
Department of Surgery, University of Louisville, 315 E. Broadway, Suite 312, Louisville, KY 40202, USA. anees.chagpar@nortonhealthcare.org
Kehdy
Farid
F
Scoggins
Charles R
CR
Martin
Robert C G
RC
Carlson
David J
DJ
Laidley
Alison L
AL
El-Eid
Souzan E
SE
McGlothin
Terre Q
TQ
Noyes
Robert D
RD
Ley
Phillip B
PB
Tuttle
Todd M
TM
McMasters
Kelly M
KM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000473:pathology; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D011877:Radionuclide Imaging; D021701:Sentinel Lymph Node Biopsy; D013909:Thorax