PMID: 25754481Mar 11, 2015Paper

Failed preoperative lymphoscintigraphy for sentinel lymph node biopsy in breast cancer, possible causes and implications for the surgery - the analysis of 3014 procedures

Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti
O CoufalZ Řehák

Abstract

The aim of the study was to review the cases of sentinel lymph node biopsy for breast cancer in which preoperative lymphoscintigraphy had shown no axillary hot spot; to assess the frequency of failed examinations and possible causes of the failure; to analyze subsequent surgical procedures and hence to provide a general recommendation on what to do in such a situation. A retrospective overview of 3014 lymphoscintigraphy examinations at the Masaryk Memorial Cancer Institute from 2001 to 2011 with a more detailed analysis of the cases with axillary hot spot visualization failure. The axillary hot spot was not shown in 71 examinations (2.4%). The frequency of failed lymphoscintigraphy during the time period did not change substantially. The possible risk factors of failed lymphoscintigraphy include: previous surgery on the breast or the axilla, obturation of the lymphatic drainage with the cancer, and the absence of the tracer injection site massage. The most common surgical procedures to respond to a failed examination were: the application of patent blue and surgical exploration of the axilla, no axillary surgery, or axillary dissection. When repeated scanning with the gamma camera through the first several hours is performed, t...Continue Reading

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