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Factors affecting sentinel node localization during preoperative breast lymphoscintigraphy.

P I Haigh1, N M Hansen, A E Giuliano

  • 1Joyce Eisenberg Keefer Breast Center and Division of Surgical Oncology, John Wayne Cancer Institute, Saint John 's Health Center, Santa Monica, California, USA.

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine
|October 19, 2000
PubMed
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The modified oblique view of the axilla (MOVA) significantly improves the identification of axillary sentinel nodes in breast cancer patients. This technique, combined with preoperative lymphoscintigraphy, allows for same-day sentinel lymph node dissection.

Area of Science:

  • Oncology
  • Nuclear Medicine
  • Surgical Pathology

Background:

  • Preoperative lymphoscintigraphy is crucial for identifying sentinel lymph nodes in breast cancer patients.
  • Previous methods have shown variable success rates for sentinel node identification.

Purpose of the Study:

  • To evaluate the effectiveness of the modified oblique view of the axilla (MOVA) in improving sentinel lymph node identification.
  • To assess the impact of patient and procedural factors on sentinel node identification and radiopharmaceutical migration kinetics.

Main Methods:

  • A prospective study involving 75 breast cancer patients undergoing preoperative lymphoscintigraphy.
  • Utilized the modified oblique view of the axilla (MOVA) and standard anterior views for imaging.
  • Analyzed factors including age, weight, breast size, biopsy method, and interval after biopsy.

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Main Results:

  • The MOVA technique successfully identified axillary sentinel nodes in 99% of cases.
  • MOVA provided superior or equivalent visualization compared to anterior views in 76% of patients.
  • Larger breast size correlated with increased radiopharmaceutical transit time; other factors showed no significant effect.

Conclusions:

  • The modified oblique view of the axilla (MOVA) enhances the identification of axillary sentinel nodes.
  • While axillary drainage is common, internal mammary and clavicular nodes can also be involved.
  • The technique facilitates same-day sentinel lymph node dissection due to short arrival times.