Mammographic and Clinical Predictors of Drainage Patterns in Breast Lymphoscintigrams Obtained During Sentinel Node Procedures

摘要

Purposecolon;The authors' purpose was to explore the association between mammographic findings and drainage patterns on lymphoscintigrams obtained during sentinel node procedures for breast carcinoma.Materials and Methodscolon;From July 1997 to March 2000, 132 patients with breast cancer who were included in a prospective mammographyhyphen;pathology correlation and staging database were imaged 2 hours after perilesional injection of 1 mCi filtered lpar;0. 22 mu;mrpar; Tchyphen;99m sulfur colloid lpar;4 ml volumerpar; before sentinel node procedures.Resultscolon;Sixtyhyphen;four percent of the scans showed axillary drainage only, 9percnt; showed axillary and internal mammary drainage, and 4percnt; revealed internal mammary drainage only. Twentyhyphen;three percent of scans showed no drainage. Of the patients who showed drainage, 17percnt; showed drainage to the internal mammary basin, and 5percnt; showed this exclusively. Internal mammary drainage was seen in 18percnt; lpar;10 of 57rpar; of lateral, 21percnt; lpar;6 of 29rpar; of medial, and 14percnt; lpar;1 of 7rpar; of subareolar lesions lpar;Pequals; NSrpar;. No drainage was seen in 22percnt; of patients with predominantly fatty mammographic parenchymal density lpar;50percnt;rpar; compared with only 8percnt; of patients with predominantly dense lpar;50percnt;rpar; parenchyma lpar;P 0.05rpar;. Failure to show drainage was more common in women older than 50 years lpar;P 0.05rpar;. Axillary sentinel nodes were identified surgically in 73percnt; of patients with negative scan findings. There was no significant association between scintigraphic drainage and mammographic soft tissue tumor size and appearance, histologic findings, or axillary node status.Conclusionscolon;Dense mammographic parenchyma and age less than 50 years are associated with identification of lymphatic drainage on lymphoscintigrams performed before sentinel node procedures in 91percnt; to 92percnt; of patients. Internal mammary drainage, present in 18percnt; of lateral and 21percnt; of medial lesions, may direct therapy to include internal mammary lymph nodes.