Exploration of inner mammary chains by isotopic lymphography

The indirect isotopic lymphography of the internal mammary lymph nodes, is an interesting method of investigations as it is the only one which allows the visualization of these nodes, quite difficult to explore. The radioactive molecule used for this study is an antimony sulfocolloid labelled by technetium-99m. This material seems to be the most suitable more for its physical than physiological properties; it is injected into the posterium wall of the rectus muscle on both sides of the medium line. The main parameters obtained from this study on 30 normal and 20 pathological patients give morphological data: number of nodes, their position within intercostal spaces, the width of both chains, their aspect, the presence of subclavicular nodes, or the intercatenar spontaneous passage. On the other hand, the semeiologic data are much more difficult to individualize because of the very great variability of those nodes. Some special shapes give us no doubt as to the spreading of the nodes; but most of the time, just a modification of the scintigram aspect at the time assures us of the extension of neoplasm. This method, almost non invasive for the patient, and for which no local reaction of intolerance has been found, allows the radiotherapist to define its scope of irradiation on each patient, instead of referring himself to literature data, which are only average values