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Sentinel Lymph Node Detection and Evidence of Axillary Lymphatic Integrity After Transaxillary Breast Augmentation: A Prospective Study Using Lymphoscintography

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Abstract

Background

The transaxillary breast augmentation (TBA) technique has gained popularity because of several advantages. However, the impact of the procedure on breast lymphatic drainage and sentinel node (SN) detection remains controversial. The objective of this study was to evaluate the lymphatic patterns and SN detection rates after TBA by using lymphoscintigraphy (LSG).

Methods

Twenty patients (40 breasts) who underwent TBA were evaluated by LSG immediately after periareolar injections of phytate-99 mTc at three time points: before TBA (Pre-LSG) and approximately 30 days (Recent-Post-LSG) and 6 months after TBA (Late-Post-LSG). Statistical analysis considered p < 0.05 significant, or p < 0.017 when Bonferroni correction was applied.

Results

All breasts drained primarily to the axillary SN. The binomial test did not show statistical differences in lymphatic drainage patterns between Pre-LSG and Recent-Post-LSG (p = 1), Pre-LSG and Late-Post-LSG (p = 0.625), and Recent-Post-LSG and Late-Post-LSG (p = 0.625). The average number of hot SN was 1.28 in Pre-LSG, 1.10 in Recent-Post-LSG, and 1.23 in Late-Post-LSG, without significant differences (p = 0.202). The average time of the first SN appearance was not significantly different (p = 0.186). Analysis of SN uptake percentage showed a significant difference between Pre-LSG and Recent-Post-LSG (p = 0.009), with a reduction of drainage magnitude in Recent-Post-LSG.

Conclusion

The preservation of axillary lymphatic drainage after TBA allowed for SN detection in all studied breasts. It seems that the applied surgical technique played an important role in axillary lymphatic integrity.

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Authors and Affiliations

  1. Department of Surgery, Federal University of Paraná, 181, General Carneiro Street, Curitiba, Parana, 80060900, Brazil

    Heitor Naoki Sado

  2. Plastic Surgery Division, Department of Surgery, Federal University of Paraná, Curitiba, Parana, Brazil

    Ruth M. Graf, Lady W. Canan, Giovana G. Romano & Gilvani A. Oliveira Cruz

  3. Department of Surgery, Federal University of Paraná, Curitiba, Parana, Brazil

    Jorge R. Timi & Jorge E. Matias

  4. CERMEN Nuclear Medicine, Curitiba, Parana, Brazil

    Airton S. Yamada & Luiz C. Woellner

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  1. Heitor Naoki Sado
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  2. Ruth M. Graf
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Correspondence to Heitor Naoki Sado.

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Sado, H.N., Graf, R.M., Canan, L.W. et al. Sentinel Lymph Node Detection and Evidence of Axillary Lymphatic Integrity After Transaxillary Breast Augmentation: A Prospective Study Using Lymphoscintography. Aesth Plast Surg 32, 879–888 (2008). https://doi.org/10.1007/s00266-008-9212-0

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  • DOI: https://doi.org/10.1007/s00266-008-9212-0

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