Journal article
Management of Contralateral Axillary Sentinel Lymph Nodes Detected on Lymphoscintigraphy for Breast Cancer
Annals of surgical oncology, Vol.20(10), pp.3317-3322
10/2013
DOI: 10.1245/s10434-013-3151-y
PMID: 23975295
Abstract
Detection of a contralateral axillary sentinel lymph node (SLN) during lymphoscintigraphy for breast cancer is rare, and its significance and management are unclear. The purpose of this study was to review our experience and analyze our results together with similar patients in the literature to identify common characteristics and propose a management strategy.A PubMed search was performed for articles describing patients in whom contralateral axillary drainage was identified on lymphoscintigraphy. Additionally, a chart review was performed of all patients who had lymphoscintigraphy for breast cancer at our institution.At our institution, two of 988 (0.3 %) consecutive patients were identified with contralateral axillary drainage on lymphoscintigraphy. Twenty-seven publications describing 105 patients with contralateral axillary drainage were found. This comprised our study group of 107 patients. Lymphoscintigraphy patterns varied depending on the history and type of prior surgery. A history of chest/axillary surgery was significantly associated with absence of an ipsilateral SLN (p < 0.05). This was observed in 84.2 % of patients with prior axillary lymph node dissection versus 33.3 % with prior SLN. Contralateral SLN biopsy was attempted in 85 patients (79.4 %); 22 (20.6 %) were positive for tumor. In 17 patients (15.9 %), the contralateral node was the only positive SLN.These findings suggest that contralateral uptake on lymphoscintigraphy, though rare (0.2 %), is clinically significant and such nodes should undergo excision. Because contralateral uptake is significantly associated with prior chest/axillary surgery, routine lymphoscintigraphy should be considered in this group, as it has potential to change disease stage and management.
Details
- Title: Subtitle
- Management of Contralateral Axillary Sentinel Lymph Nodes Detected on Lymphoscintigraphy for Breast Cancer
- Creators
- Ingrid Lizarraga - Department of Surgery University of Iowa Hospitals and Clinics Iowa City IA USACarol Scott-Conner - Department of Surgery University of Iowa Hospitals and Clinics Iowa City IA USASaima Muzahir - Department of Radiology University of Iowa Hospitals and Clinics Iowa City IA USARonald Weigel - Department of Surgery University of Iowa Hospitals and Clinics Iowa City IA USAMicheal Graham - Department of Radiology University of Iowa Hospitals and Clinics Iowa City IA USASonia Sugg - Department of Surgery University of Iowa Hospitals and Clinics Iowa City IA USA
- Resource Type
- Journal article
- Publication Details
- Annals of surgical oncology, Vol.20(10), pp.3317-3322
- Publisher
- Springer US; Boston
- DOI
- 10.1245/s10434-013-3151-y
- PMID
- 23975295
- ISSN
- 1068-9265
- eISSN
- 1534-4681
- Language
- English
- Date published
- 10/2013
- Academic Unit
- Radiology; Molecular Physiology and Biophysics; Anatomy and Cell Biology; Surgery; Radiation Oncology; Biochemistry and Molecular Biology
- Record Identifier
- 9984025281002771
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