Postoperative axillary lymphoscintigraphy in the management of breast cancer

Postoperative axillary lymphoscintigrams have been performed according to a technique of two-staged injection in 313 patients who had undergone a radical mastectomy with axillary dissection for breast cancer. Total absence of visualization of residual nodes suggests that dissection could be said to be complete in only 35.8% of the investigated patients, or because of metastatic disease causing blockage. The visualized residual nodes in patients represent a risk of developing nodal relapse, especially with positive pathological demonstration of axillary node invasion and without nodal irradiation. On the other hand, when the investigation showed the interruption of the lymphatic pathways of the arm, patients developed upper limb edemas more frequently. It is concluded that this simple and non traumatic technique is of value in order to assess the immediate postoperative axillary nodal status, and that it may influence the treatment of the patients.