Skip to main content
SpringerLink
Log in

Value of axillary lymphoscintigraphy in patients with operated breast carcinoma

  • Original Article
  • Published:
Annals of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Purpose

To evaluate axillary dissection with axillary lymphoscintigraphy (ALS) in postoperative patients with breast carcinoma and its role in adjuvant radiotherapy (RT). Additionally, to define axillary dissection as complete and incomplete with ALS and to correlate it with the number of removed lymph nodes.

Material and Methods

In the last two years, 121 women were studied four weeks after operation. Bilateral second interdigital subcutaneous injections were performed for ALS. Complete and incomplete axillary dissection were interpreted according to the number of surgically removed lymph nodes. ALS was interpreted as complete if no accumulation was shown.

Results

There was a good correlation between the number of surgically removed lymph nodes and complete and incomplete interpretation on ALS (p < 0.004). The number of removed lymph nodes was equal to or greater than 15 in 72% patients with complete dissection according to ALS. Of 48 patients with surgically incomplete axillary dissection, 18 (38%) showed no accumulation in the axillary region, while 25 of 68 (37%) patients with surgically complete dissection showed accumulation in the axillary region and were interpreted as incomplete according to ALS. Indication of RT was changed after ALS in patients with 1 to 3 involved lymph nodes. While RT was not considered in 12 of these patients before ALS, they were included in RT planning. On the other hand, 17 patients, considered for RT previously, were excluded from RT planning after ALS.

Conclusion

Evaluation of axillary dissection with ALS especially in suspicious patients with 1 to 3 lymph node metastases might prevent unnecessary morbidity and can be useful in selecting patients who truly need axillary irradiation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bonadonna G, Valagussa P. Adjuvant chemoendocrine therapy in breast cancer.J Clin Oncol 1986; 4: 451–454.

    PubMed  CAS  Google Scholar 

  2. Early Breast Cancer Trials’ Collaborative Group. Effect of adjuvant tamoxifen and cytotoxic therapy on mortality in early breast cancer: an overview of 61 randomized trials among 28896 women.N Engl J Med 1988; 319:1681–1692.

    Google Scholar 

  3. Gregory MS, Frederick LM, Kevin D, Mohammed MM, Kimberley CC, David SR, et al. Total axillary lymphadenec-tomy in the management of breast cancer.Arch Surg 1991; 126: 1336–1342.

    Google Scholar 

  4. Osborne CK, Clark GM, Ravdin PM. Adjuvant systemic therapy of primary breast cancer. In: Harris Lippmann ME, Morrow M, Helman S, eds.Disease of the breast. Philadelphia; J.B. Lippincott, 1996: 548–578.

    Google Scholar 

  5. Warmuth MA, Bowen G, Prosnitz LR, Chu L, Broadwater G, Peterson B, et al. Complications of axillary lymph node dissection for carcinoma of the breast: A report based on a patient survey.American Cancer Society 1998; 38 (7): 1362–1368.

    Google Scholar 

  6. Fisher B, Redmond C, Fisher ER, Brauer M, Wolmark N, Wicherham DL, et al. Ten year results of randomized clinical trial comparing radical mastectomy and total mastectomy with or without radiation.N Engl J Med 1985; 321: 674–681.

    Google Scholar 

  7. Haffy BG, McKhann C, Beinfield M, Fischer D, Fischer JJ. Breast conservation therapy without axillary dissection: a rational treatment strategy in selected patients.Arch Surg 1993; 128: 1315–1319.

    Google Scholar 

  8. Mattheiem W, Bourgeois P, Delcorde A, et al. Axillary dissection in breast cancer revisited.Eur J Surg Oncol 1989; 15: 490–495.

    PubMed  CAS  Google Scholar 

  9. Mc-Lean RG, Ege GN. Prognostic value of axillary lympho-scintigraphy in breast cancer patients.J Nucl Med 1986; 27: 1116–1124.

    CAS  Google Scholar 

  10. Axelsson CK, Blichert-Toff M. Low risk breast cancer patients treated by mastectomy and lower axillary dissection: the present status of the Danish Breast Cancer Cooperative Group Trial 77-A.Acta Oncol 1988; 27: 605–609.

    Article  PubMed  CAS  Google Scholar 

  11. Arriagada R, Rutqvist CE, Mattsson A, Kramar A, Rotstein S. Adequate locoregional treatment for early breast cancer may prevent secondary dissemination.J Clin Oncol 1995; 13: 2869–2878.

    PubMed  CAS  Google Scholar 

  12. Fisher B, Dignam J, Mamounas EP, et al. Sequential meth-otrexate and fluorouracil for the treatment of node negative breast cancer patients with estrogen receptor negative tumors: eight year results from the National Surgical Adjuvant Breast and Bowel project (NSABP) B-13 and first report of findings from (NSABP) B-19 comparing metho-trexate, and fluorouracil with conventional cyclophospha-mide, methotrexate and fluorouracil.J Clin Oncol 1996; 14: 1982–1992.

    PubMed  CAS  Google Scholar 

  13. Rubens RD, Hayward JL, Knight RK, et al. Controlled trial of adjuvant chemotherapy with melphalan for breast cancer.Lancet 1983; 1: 839–843.

    Article  PubMed  CAS  Google Scholar 

  14. Castiglione-Gertsch M, Johnsen C, Goldhirsch A, et al. The International (Ludwig) Breast Cancer Study Group Trials I-IV: 15 years follow-up.Ann Oncol 1994; 5: 717–724.

    PubMed  CAS  Google Scholar 

  15. Haagensen CD.Diseases of the breast, 3rd ed. Philadelphia; W.B. Saunders, 1986.

    Google Scholar 

  16. Kissin MW, Thompson EM, Price AB, Slavin G, Kark AE. The inadequacy of axillary sampling in breast cancer.Lancet 1982; 2: 1210–1212.

    Article  Google Scholar 

  17. Steele RJC, Forrest APM, Gibson T, Stewart HJ, Chetty U. The efficacy of lower axillary sampling in obtaining lymph node status in breast cancer: a controlled randomized trial.Br J Surg 1985; 72: 368–369.

    Article  PubMed  CAS  Google Scholar 

  18. Graversen HP, Blichert-Toft M, Andersen JA, et al. Breast Cancer: risk of axillary recurrence in node negative patients following partial dissection of the axilla.Eur J Surg Oncol 1988; 14: 407–412.

    PubMed  CAS  Google Scholar 

  19. Siegel BM, Mayzel KA, Love SM. Level I and II axillary dissection in the treatment of early-stage breast cancer: an analysis of 259 consecutive patients.Arch Surg 1990; 125: 1144–1147.

    PubMed  CAS  Google Scholar 

  20. Rosen PP, Lesser ML Kinne DW, Beattie EJ. Discontinuous or “skip” metastases in breast carcinoma: analysis of 1228 axillary dissection.Ann Surg 1983; 197: 276–283.

    Article  PubMed  CAS  Google Scholar 

  21. Veronesi U, Rilke F, Luini A, et al. Distribution of axillary node metastases by level of invasion: an analysis of 539 cases.Cancer 1987; 313: 683–687.

    Google Scholar 

  22. Delouche G, Bachelot F, Premont M, Kurtz JM. Conservation treatment of early breast cancer: long term results and complications.Int J Radiat Oncol Biol Phys 1987; 13: 29–34.

    PubMed  CAS  Google Scholar 

  23. Langlands AO, Prescott RJ, Hamilton TA. Clinical trial in the management of operable breast cancer.Br J Surg 1980; 67: 170–174.

    Article  PubMed  CAS  Google Scholar 

  24. Touboul E, Buffat L, Belkacemi Y, Leranc JP, Uzan S, Lhuillier P, et al. Local recurrences and distant metastases after breast conserving surgery and radiation therapy for early breast cancer.Int J Radiat Oncol Biol Phys 1999; 43: 25–38.

    PubMed  CAS  Google Scholar 

  25. Kuske RR, Hayden D, Bischoff R, Farr GH, Fineberg BB. The impact of extracapsular axillary nodal extension (ECE) with and without irradiation on patterns of failure and survival from breast cancer (Abstr).Int J Radiat Oncol Biol Phys 1996; 36 (suppl 1): 277.

    Article  Google Scholar 

  26. Marks LB, Helperin EC, Prosnitz LR, et al. Post mastectomy radiotherapy following adjuvant chemotherapy and autologous bone marrow transplantation for breast cancer patients with ≥10 positive axillary lymph nodes.Int J Radiat Oncol 1992; 23: 1021–1026.

    Article  CAS  Google Scholar 

  27. Calitchi E, Otmezquine Y, Feuilhade F, et al. External irradiation prior to conservative surgery for breast cancer treatment.Int J Radiat Oncol Biol Phys 1991; 21: 325–329.

    PubMed  CAS  Google Scholar 

  28. Pierquin B, Huart J, Raynal M, et al. Conservative treatment for breast cancer: long term results (15 years).Radiother Oncol 1991; 20: 16–23.

    Article  PubMed  CAS  Google Scholar 

  29. Yarnold JR. Selective avoidance of lymphatic irradiation in the conservative management of breast cancer.Radiother Oncol 1984; 2: 79–92.

    Article  PubMed  CAS  Google Scholar 

  30. Taylor ME, Perez CA, Levitt SH. Breast: Locally advanced (T3 and T4), inflammatory and recurrent tumors.Principles and practice of radiation oncology. Third ed. Perez CA, Brady LW, eds. Philadelphia; Lippincott-Raven Publishers, 1997: 1415–1443.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Bülbülderesi Caddesi, 124/3, 06660, Küçukesat/Ankara, Turkey

    Gülin Vural, Elçin Özalp, Bülent Turgut & Nur Erçakmak

  2. Department of Radiation Oncology, Ankara Oncology Hospital, Ankara, Turkey

    Tamer Çalikoğlu, Ali Riza Üçer & Sema Durmuş

Authors
  1. Gülin Vural
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elçin Özalp
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tamer Çalikoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ali Riza Üçer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sema Durmuş
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Bülent Turgut
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Nur Erçakmak
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gülin Vural.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vural, G., Özalp, E., Çalikoğlu, T. et al. Value of axillary lymphoscintigraphy in patients with operated breast carcinoma. Ann Nucl Med 18, 309–313 (2004). https://doi.org/10.1007/BF02984469

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02984469

Key words

Search

Navigation