CLINICAL SIGNIFICANCE OF MAMMARY LYMPHOSCINTIGRAPHY TO VISUALIZE THE LYMPHATIC DRAINAGE SITES IN BREAST CANCER

Aim: The aim of this study is to examine the lymphatic drainage sites in breast cancer and to evaluate the clinical significance of mammary lymphoscintigraphy. Material-methods: Seventy patients (pts) with palpable breast cancer had 4 peritumoral injections of Tc99m-Rhennium sulfide colloid. Static images of thorax and axilla were obtained 1 -2 hours later in anterior and lateral projections with ADAC-Vertex gamma camera. All patients had modified radical mastectomy and axillary dissection. Results: The tumor masses were located in outer quadrant in 34 pts, inner quadrant in 12 and centrally in 24 pts. Lymphoscintigraphy revealed unique axillary drainage in 38 pts, whereas only 5 showed pure internal mammary (IM) drainage. In 14 pts there were drainage to both sides. In 11 pts no lymphatic drainage was observed. Of these, 7 had metastatic axillary nodes. Fifty per cent axillary and 25% IM drainage were observed in inner quadrant lesions. Whereas 76% axillary and 20% IM drainage were seen in inner quadrant lesions. Conclusion: Lymphoscintigraphy may be useful in determining the presence of drainage to IM lymphatics for radiotherapy planning and to visualize the site of sentinel lymph node for biopsy.

Keywords: mammarian lymphoscintigraphy carcinoma, lymphatic drainage