Abstract
BackgroundPreoperative lymphoscintigraphy is one of the three methods of evaluating sentinel nodes in patients with breast cancer; however, it has been reported to have a high false negative rate.Case presentationsWe report here two cases where the preoperative lymphoscintigraphy was found to be fallacious. A 44-year-old female with T2N0 breast cancer underwent preoperative lymphoscintigraphy with Tc99 sulfur colloid which failed to show any uptake in axilla or internal mammary chain. Intraoperative scintigraphy with blue dye and hand held gamma probe identified sentinel lymph node in axilla. Another patient with T2N0 lesion underwent preoperative lymphoscintigraphy which showed a sentinel lymph node in axilla and another in supraclevicular fossa. Intraoperative scintigraphy failed to show supraclevicular node however axillary node was correctly identified.ConclusionThese two cases further strengthen the need to carry out triple test in identification of sentinel lymph node in patients with breast cancer. It also demonstrates the fallacies of preoperative lymphoscintigraphy.
Highlights
Preoperative lymphoscintigraphy is one of the three methods of evaluating sentinel nodes in patients with breast cancer; it has been reported to have a high false negative rate.Case presentations: We report here two cases where the preoperative lymphoscintigraphy was found to be fallacious
These two cases further strengthen the need to carry out triple test in identification of sentinel lymph node in patients with breast cancer
It demonstrates the fallacies of preoperative lymphoscintigraphy
Summary
Metastasis to the axillary lymph node is the single most important prognostic factor in breast cancer. We report here two unusual cases of non-visualization or abnormal visualization during preoperative lymphoscintigraphy; both of these cases were subsequently identified and biopsied intraoperatively using a combination of blue dye and hand held gamma probe. Case 2 A 42-year-old female presented with lump in left breast of 1-month duration She was a known case of carcinoma breast and had undergone right modified radical mastectomy 7 years back followed by chest wall radiotherapy and 6 cycles of CMF chemotherapy. Http://www.wjso.com/content/3/1/31 advance tumor in the outer quadrant and separation was not achieved on scintigraphy, while the erroneous supra clavicular node in the other was probably due to the spillage of radioactive material at the time of injection, which was subsequently washed off during the part preparation and no signal was obtained at intraoperative gamma probe assisted SLNB
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