Lymphoscintigraphy--techniques and applications in the management of breast carcinoma

Radiocolloid lymphoscintigraphy is a versatile, simple technique which has been utilized extensively in the assessment of lymphatic function and structure in anatomic regions accessible to neither clinical examination nor radiocontrast lymphography, as well as in circumstances where radiocontrast lymphography is not feasible. The most important requirement for an effective study are: (a) Determination of the appropriate injection site for reproducibly visualizing the majority of the lymphatics under study and, (b) use of an agent with the optimum properties of a preformed small, uniform, well-dispersed particle colloid. Multiple applications of lymphoscintigraphy in the patient with breast carcinoma have demonstrated its value in distinguishing abnormalities of the internal mammary lymphatics shown to have significant prognostic implications, in providing accurate localization of the parasternal lymphatics for radiation therapy and its potential for determining the status of axillary lymphatics in lieu of surgical intervention. The following review is based on an experience of over 6500 studies in 5550 patients with breast carcinoma.