OtherCLINICAL INVESTIGATIONS

Lymphoscintigraphy and Sentinel Node Localization in Breast Cancer Patients: A Comparison Between 1-Day and 2-Day Protocols

Henry W.D. Yeung, Hiram S. Cody III, Alla Turlakow, Elyn R. Riedel, Jane Fey, Mithat Gonen, Rodolfo Nuñez, Samuel D. Yeh and Steven M. Larson
Journal of Nuclear Medicine March 2001, 42 (3) 420-423;

Article Figures & Data

Figures

  • FIGURE 1.
    FIGURE 1.

    Anterior (A and C) and left lateral (B and D) transmission images show injection site in left breast and focal uptake in sentinel node in left axilla, seen only on 2-h delayed images. (A and B) Early images at 30 min. (C and D) Delayed images at 2 h.

Tables

  • TABLE 1

    Comparison of Patients in Two Protocols

    Parameter1-d protocol2-d protocol
    No. of cases514152
    Mean age* (y)57.3 (22–88)55.2 (31–87)
    Size of primary† (mean ± SD)1.4 ± 0.91.6 ± 1.1
    Histology
        Ductal387 (75.3%)117 (77.0%)
        Lobular44 (8.6%)10 (6.6%)
        Other‡83 (16.0%)89 (16.4%)
    Positive SLN (%)3037
    Prior excisional biopsy235 (45.7%)89 (58.6%)
    Site
        Upper outer quadrant270 (52.5%)91 (59.9%)
        Upper inner quadrant87 (16.9%)12 (7.9%)
        Lower outer quadrant49 (9.5%)25 (16.4%)
        Lower inner quadrant31 (6.0%)6 (3.9%)
        Central63 (12.3%)13 (8.6%)
        Unknown or no cancer found14 (2.7%)5 (3.3%)

    • ↵* Range in parentheses.

    • ↵† Invasive component only. Patients with unknown size or diagnosis of ductal carcinoma in situ (no invasive component) or patients with no cancer found at time of resection were not included.

    • ↵‡ Includes 11 cases with no cancer found in 1-d protocol and 3 cases with no cancer found in 2-d protocols.

  • TABLE 2

    Successful Localization on Lymphoscintigram

    Image1-d protocol2-d protocol
    Early (30 min)352 (69%)104 (68%)
    Late (2 h)Not done130 (86%)
    Overall352 (69%)130 (86%)
  • TABLE 3

    Success Rate of Sentinel Node Localization

    Localization1-d protocol2-d protocol
    SLN by isotope (%)476 (92.8)147 (97.4)
    SLN by blue dye (%)414 (80.7)138 (91.4)
    SLN by either isotope or blue dye (%)500* (97.5)150† (99.3)

    • ↵* Thirteen failures, one patient missing all data.

    • ↵† One failure, one patient missing all data.

  • TABLE 4

    Number of Sentinel Nodes Found

    Sentinel nodes found1-d protocol2-d protocol
    By isotope (% of total)1084 (85.1)367 (88.4)
    By blue dye (% of total)881 (69.2)291 (70.1)
    Total1274415
    Average no. of nodes/axilla2.52.8
    Isotope/dye concordance*97%95%

    • ↵* At least one lymph node with both isotope and dye, in patients in whom both isotope and dye were found in axilla.

  • TABLE 5

    Distribution of Procedures Performed by Surgeons

    SurgeonNo. of prior lymphatic mappingsNo. of 1-d protocols (% of total)No. of 2-d protocols (% of total)
    A346131 (25.5)71 (46.7)
    B23995 (18.5)18 (11.8)
    C1616 (3.1)1 (0.7)
    D4108 (21.0)14 (9.2)
    E16731 (6.0)1 (0.7)
    F3861 (11.9)16 (10.5)
    H10059 (11.5)28 (18.4)
    I4913 (2.5)3 (2.0)
    Total959514 (100)152 (100)

    • Surgeon G did not do any Sentinel node mapping during the study period.

Back to top

In this issue

Print
Download PDF
Article Alerts
Email Article
Citation Tools
Bookmark this article

Jump to section