Preoperative upper limb lymphatic function in breast cancer surgery.
OBJECTIVE
To describe the preoperative upper limb lymphoscintigraphic pattern in women with breast cancer.


METHODS
Thirty-seven patients undergoing lymphoscintigraphy within 30 days of surgery were investigated. Lymphoscintigraphic studies of 37 upper limbs ipsilateral to surgery and 32 contralateral upper limbs were performed. The examination protocol consisted in obtaining static images of the upper limb in semi-flexion after 10 minutes, and 1 and 2 hours after subcutaneous injection of 1 mCi (37 MBq) of Tc-99m-dextran in the dorsum of the hand. The velocity of axillary lymph node visualization (I, visible at 10 minutes; II, 1 hour; III, 2 hours; and IV, invisible) and degree (intensity) of nodal uptake (a, marked; b, moderate; c,mild; and d, absent) were analyzed.


RESULTS
Optimal lymphatic functional pattern (Ia) was observed in four (11%) patients, in the ipsilateral upper limb, and six (19%), in the contralateral upper limb. Worse condition was observed in three (8%) patients (IVd) in the ipsilateral upper limb and two (6%) patients in the contralateral upper limb. The remaining patients showed intermediate states of velocity and uptake intensity.


CONCLUSIONS
This study found relevant changes in preoperative lymphoscintigraphy, demonstrating preexisting functional differences in the lymphatic system.
Departamento de Ginecologia, Obstetrícia e Mastologia, Universidade Estadual Paulista (UNESP), São Paulo, SP, Brazil. rezendelaura@hotmail.com
Laura Ferreira de
LF
Rezende
Felipe Vilela
FV
Pedras
Celso Dario
CD
Ramos
Maria Salete Costa
MS
Gurgel
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D003911:Dextrans; D005260:Female; D006801:Humans; D008208:Lymphatic System / Q000503:physiopathology*; D008209:Lymphedema / Q000517:prevention & control; D061305:Lymphoscintigraphy / Q000379:methods; D008875:Middle Aged; D015609:Organotechnetium Compounds; D011237:Predictive Value of Tests; D011300:Preoperative Care; D019275:Radiopharmaceuticals; D034941:Upper Extremity
D003911:Dextrans; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C034146:technetium Tc 99m dextran