Pre-operative lymphoscintigraphy before sentinel lymph node biopsy for breast cancer
Received 28 June 2009; received in revised form 16 September 2009; accepted 6 October 2009. published online 13 November 2009.
Abstract
Pre-operative lymphoscintigram for axillary sentinel lymph node biopsy (SLNB) may not be required for successful SLNB. The 117 consecutive patients who underwent SLNB had pre-operative lymphoscintigraphy. The operating surgeon was blinded to the results of the lymphoscintigram before SLNB. After SLNB was complete, the surgeon was unblinded to the results of the lymphoscintigram; re-exploration carried out if more nodes were predicted on the lymphoscintigram. 116 patients (99%) had successful SLNB before unblinding. In 85 patients (73%), operative findings corresponded with scintigraphic findings. In 26 patients (22%), the lymphoscintigram predicted more sentinel nodes than had been found; further nodes were identified and excised in only 4 patients (3%). None were positive for cancer. SLNB was successful in 99% of cases without pre-operative lymphoscintigraphy. Only 3% of patients had further nodes identified as a result of the lymphoscintigram. Pre-operative lymphoscintigraphy does not improve the ability to perform axillary SLNB during breast cancer surgery.
Breast Unit, Airedale General Hospital, Skipton Road, Steeton BD20 6TD, United Kingdom
Corresponding author. Department of Breast Surgery, c/o Mr. Nejim's Secretary, Airedale General Hospital, Skipton Road, Steeton BD20 6TD, United Kingdom. Tel.: +44 7799 40 20 10; fax: +44 1535 292229.