Mammary sentinel lymphoscintigraphy in breast cancer

Objective: To evaluate the methods and clinical value of mammary sentinel lymphoscintigraphy in breast cancer. Methods: 117 patients with breast tumor in stage T1-2N0 were examined before sentinel node biopsy were considered. Some of them were compared in different injection volume at both side and several cases with SPECT/CT tomographic fusions. 13 patients were subdermally injected with 55.5 MBq (0.5 ml) 99Tcm-DTPA-human serum albumin (HSA) on the surface of the lesion, 50 patients with 92.5 MBq (4 ml) unfiltered 99Tcm-sulfur colloid (SC) in four divided doses around the lesion and 54 patients in the upper part of the lesion with the same volume of the SC in one-point-injection. Results: The sentinel lymph node (SLN) could quickly be shown by any of three methods but the best time of view and number of lymph nodes differed personly and mainly affected by injection depth and volume. It was showed that the 3rd method could find more juxtaclavicular, supraclavicular and internal mammary nodes. SLN were successfully identified in 69.2% with HSA in 30 min and over 84% with SC in 2 h. SPECT/CT tomographic fusions were more helpful to recognize SLN and abnormal lymphatic drainage. Conclusion: The mammary sentinel lymphoscintigraphy in breast cancer is differ from past lymphatic imaging and is essential for localizing SLN correctly, identifying abnormal lymphatic drainage and designing new therapeutic regime