Management of Contralateral Axillary Sentinel Lymph Nodes Detected on Lymphoscintigraphy for Breast Cancer
Background Detection of a contralateral axillary sentinel lymph node (SLN) during lymphoscintigraphy for breast cancer is rare, and its significance and management are unclear. The purpose of this study was to review our experience and analyze our results together with similar patients in the litera...
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| Veröffentlicht in: | Annals of surgical oncology 2013-10, Vol.20 (10), p.3317-3322 |
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| creator | Lizarraga, Ingrid M. Scott-Conner, Carol E. H. Muzahir, Saima Weigel, Ronald J. Graham, Micheal M. Sugg, Sonia L. |
| description | Background
Detection of a contralateral axillary sentinel lymph node (SLN) during lymphoscintigraphy for breast cancer is rare, and its significance and management are unclear. The purpose of this study was to review our experience and analyze our results together with similar patients in the literature to identify common characteristics and propose a management strategy.
Methods
A PubMed search was performed for articles describing patients in whom contralateral axillary drainage was identified on lymphoscintigraphy. Additionally, a chart review was performed of all patients who had lymphoscintigraphy for breast cancer at our institution.
Results
At our institution, two of 988 (0.3 %) consecutive patients were identified with contralateral axillary drainage on lymphoscintigraphy. Twenty-seven publications describing 105 patients with contralateral axillary drainage were found. This comprised our study group of 107 patients. Lymphoscintigraphy patterns varied depending on the history and type of prior surgery. A history of chest/axillary surgery was significantly associated with absence of an ipsilateral SLN (
p
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| doi_str_mv | 10.1245/s10434-013-3151-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1430398463</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1430398463</sourcerecordid><originalsourceid>FETCH-LOGICAL-c438t-923f5e08f52940e11dcbb3545a46f5eb962b35e1ba2b006be95526f0925091ca3</originalsourceid><addsrcrecordid>eNp1kU2P0zAQhi3EipaFH8AFWeLCJazHH2l8LOVrpe5yAM6Wk066qRK72Km0-fc7VRaEkPbij5lnxq_nZewNiA8gtbnKILTShQBVKDBQTM_YEgxFdFnBczqLsiqsLM2Cvcz5IASslDAv2EIquzLSmiU73Pjg9zhgGHls-SaGMfnej0grX993fe_TxH9QugvY8-00HO_4bdxh5p9wxGbEHY9hjsfcdMTtkz_eTbyNiX9M6PPINz40mF6xi9b3GV8_7pfs15fPPzffiu33r9eb9bZotKpG0qtag6JqSaAWCLBr6loZbbwuKVHbUtIVofayFqKs0Rojy1ZYaYSFxqtL9n7ue0zx9wnz6IYuN0g_CRhP2YFWQtlKl4rQd_-hh3hKgdSdKQ1gKwtEwUw1KeacsHXH1A00FwfCnY1wsxGOjHBnI9xENW8fO5_qAXd_K_5MngA5A5lSYY_pn6ef7PoAG6KTsQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1434119891</pqid></control><display><type>article</type><title>Management of Contralateral Axillary Sentinel Lymph Nodes Detected on Lymphoscintigraphy for Breast Cancer</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Lizarraga, Ingrid M. ; Scott-Conner, Carol E. H. ; Muzahir, Saima ; Weigel, Ronald J. ; Graham, Micheal M. ; Sugg, Sonia L.</creator><creatorcontrib>Lizarraga, Ingrid M. ; Scott-Conner, Carol E. H. ; Muzahir, Saima ; Weigel, Ronald J. ; Graham, Micheal M. ; Sugg, Sonia L.</creatorcontrib><description>Background
Detection of a contralateral axillary sentinel lymph node (SLN) during lymphoscintigraphy for breast cancer is rare, and its significance and management are unclear. The purpose of this study was to review our experience and analyze our results together with similar patients in the literature to identify common characteristics and propose a management strategy.
Methods
A PubMed search was performed for articles describing patients in whom contralateral axillary drainage was identified on lymphoscintigraphy. Additionally, a chart review was performed of all patients who had lymphoscintigraphy for breast cancer at our institution.
Results
At our institution, two of 988 (0.3 %) consecutive patients were identified with contralateral axillary drainage on lymphoscintigraphy. Twenty-seven publications describing 105 patients with contralateral axillary drainage were found. This comprised our study group of 107 patients. Lymphoscintigraphy patterns varied depending on the history and type of prior surgery. A history of chest/axillary surgery was significantly associated with absence of an ipsilateral SLN (
p
< 0.05). This was observed in 84.2 % of patients with prior axillary lymph node dissection versus 33.3 % with prior SLN. Contralateral SLN biopsy was attempted in 85 patients (79.4 %); 22 (20.6 %) were positive for tumor. In 17 patients (15.9 %), the contralateral node was the only positive SLN.
Conclusions
These findings suggest that contralateral uptake on lymphoscintigraphy, though rare (0.2 %), is clinically significant and such nodes should undergo excision. Because contralateral uptake is significantly associated with prior chest/axillary surgery, routine lymphoscintigraphy should be considered in this group, as it has potential to change disease stage and management.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-013-3151-y</identifier><identifier>PMID: 23975295</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Adult ; Breast cancer ; Breast Neoplasms - diagnostic imaging ; Breast Neoplasms - pathology ; Breast Neoplasms - surgery ; Breast Oncology ; Carcinoma, Ductal, Breast - diagnostic imaging ; Carcinoma, Ductal, Breast - pathology ; Carcinoma, Ductal, Breast - surgery ; Carcinoma, Lobular - diagnostic imaging ; Carcinoma, Lobular - pathology ; Carcinoma, Lobular - surgery ; Female ; Follow-Up Studies ; Humans ; Lymph Nodes - diagnostic imaging ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm Staging ; Oncology ; Prognosis ; Radionuclide Imaging ; Radiopharmaceuticals ; Retrospective Studies ; Sentinel Lymph Node Biopsy ; Surgery ; Surgical Oncology</subject><ispartof>Annals of surgical oncology, 2013-10, Vol.20 (10), p.3317-3322</ispartof><rights>Society of Surgical Oncology 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-923f5e08f52940e11dcbb3545a46f5eb962b35e1ba2b006be95526f0925091ca3</citedby><cites>FETCH-LOGICAL-c438t-923f5e08f52940e11dcbb3545a46f5eb962b35e1ba2b006be95526f0925091ca3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-013-3151-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-013-3151-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23975295$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lizarraga, Ingrid M.</creatorcontrib><creatorcontrib>Scott-Conner, Carol E. H.</creatorcontrib><creatorcontrib>Muzahir, Saima</creatorcontrib><creatorcontrib>Weigel, Ronald J.</creatorcontrib><creatorcontrib>Graham, Micheal M.</creatorcontrib><creatorcontrib>Sugg, Sonia L.</creatorcontrib><title>Management of Contralateral Axillary Sentinel Lymph Nodes Detected on Lymphoscintigraphy for Breast Cancer</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
Detection of a contralateral axillary sentinel lymph node (SLN) during lymphoscintigraphy for breast cancer is rare, and its significance and management are unclear. The purpose of this study was to review our experience and analyze our results together with similar patients in the literature to identify common characteristics and propose a management strategy.
Methods
A PubMed search was performed for articles describing patients in whom contralateral axillary drainage was identified on lymphoscintigraphy. Additionally, a chart review was performed of all patients who had lymphoscintigraphy for breast cancer at our institution.
Results
At our institution, two of 988 (0.3 %) consecutive patients were identified with contralateral axillary drainage on lymphoscintigraphy. Twenty-seven publications describing 105 patients with contralateral axillary drainage were found. This comprised our study group of 107 patients. Lymphoscintigraphy patterns varied depending on the history and type of prior surgery. A history of chest/axillary surgery was significantly associated with absence of an ipsilateral SLN (
p
< 0.05). This was observed in 84.2 % of patients with prior axillary lymph node dissection versus 33.3 % with prior SLN. Contralateral SLN biopsy was attempted in 85 patients (79.4 %); 22 (20.6 %) were positive for tumor. In 17 patients (15.9 %), the contralateral node was the only positive SLN.
Conclusions
These findings suggest that contralateral uptake on lymphoscintigraphy, though rare (0.2 %), is clinically significant and such nodes should undergo excision. Because contralateral uptake is significantly associated with prior chest/axillary surgery, routine lymphoscintigraphy should be considered in this group, as it has potential to change disease stage and management.</description><subject>Adult</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - diagnostic imaging</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - surgery</subject><subject>Breast Oncology</subject><subject>Carcinoma, Ductal, Breast - diagnostic imaging</subject><subject>Carcinoma, Ductal, Breast - pathology</subject><subject>Carcinoma, Ductal, Breast - surgery</subject><subject>Carcinoma, Lobular - diagnostic imaging</subject><subject>Carcinoma, Lobular - pathology</subject><subject>Carcinoma, Lobular - surgery</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Lymph Nodes - diagnostic imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Prognosis</subject><subject>Radionuclide Imaging</subject><subject>Radiopharmaceuticals</subject><subject>Retrospective Studies</subject><subject>Sentinel Lymph Node Biopsy</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU2P0zAQhi3EipaFH8AFWeLCJazHH2l8LOVrpe5yAM6Wk066qRK72Km0-fc7VRaEkPbij5lnxq_nZewNiA8gtbnKILTShQBVKDBQTM_YEgxFdFnBczqLsiqsLM2Cvcz5IASslDAv2EIquzLSmiU73Pjg9zhgGHls-SaGMfnej0grX993fe_TxH9QugvY8-00HO_4bdxh5p9wxGbEHY9hjsfcdMTtkz_eTbyNiX9M6PPINz40mF6xi9b3GV8_7pfs15fPPzffiu33r9eb9bZotKpG0qtag6JqSaAWCLBr6loZbbwuKVHbUtIVofayFqKs0Rojy1ZYaYSFxqtL9n7ue0zx9wnz6IYuN0g_CRhP2YFWQtlKl4rQd_-hh3hKgdSdKQ1gKwtEwUw1KeacsHXH1A00FwfCnY1wsxGOjHBnI9xENW8fO5_qAXd_K_5MngA5A5lSYY_pn6ef7PoAG6KTsQ</recordid><startdate>20131001</startdate><enddate>20131001</enddate><creator>Lizarraga, Ingrid M.</creator><creator>Scott-Conner, Carol E. H.</creator><creator>Muzahir, Saima</creator><creator>Weigel, Ronald J.</creator><creator>Graham, Micheal M.</creator><creator>Sugg, Sonia L.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20131001</creationdate><title>Management of Contralateral Axillary Sentinel Lymph Nodes Detected on Lymphoscintigraphy for Breast Cancer</title><author>Lizarraga, Ingrid M. ; Scott-Conner, Carol E. H. ; Muzahir, Saima ; Weigel, Ronald J. ; Graham, Micheal M. ; Sugg, Sonia L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-923f5e08f52940e11dcbb3545a46f5eb962b35e1ba2b006be95526f0925091ca3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - diagnostic imaging</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - surgery</topic><topic>Breast Oncology</topic><topic>Carcinoma, Ductal, Breast - diagnostic imaging</topic><topic>Carcinoma, Ductal, Breast - pathology</topic><topic>Carcinoma, Ductal, Breast - surgery</topic><topic>Carcinoma, Lobular - diagnostic imaging</topic><topic>Carcinoma, Lobular - pathology</topic><topic>Carcinoma, Lobular - surgery</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Lymph Nodes - diagnostic imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Oncology</topic><topic>Prognosis</topic><topic>Radionuclide Imaging</topic><topic>Radiopharmaceuticals</topic><topic>Retrospective Studies</topic><topic>Sentinel Lymph Node Biopsy</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lizarraga, Ingrid M.</creatorcontrib><creatorcontrib>Scott-Conner, Carol E. H.</creatorcontrib><creatorcontrib>Muzahir, Saima</creatorcontrib><creatorcontrib>Weigel, Ronald J.</creatorcontrib><creatorcontrib>Graham, Micheal M.</creatorcontrib><creatorcontrib>Sugg, Sonia L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lizarraga, Ingrid M.</au><au>Scott-Conner, Carol E. H.</au><au>Muzahir, Saima</au><au>Weigel, Ronald J.</au><au>Graham, Micheal M.</au><au>Sugg, Sonia L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Management of Contralateral Axillary Sentinel Lymph Nodes Detected on Lymphoscintigraphy for Breast Cancer</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2013-10-01</date><risdate>2013</risdate><volume>20</volume><issue>10</issue><spage>3317</spage><epage>3322</epage><pages>3317-3322</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
Detection of a contralateral axillary sentinel lymph node (SLN) during lymphoscintigraphy for breast cancer is rare, and its significance and management are unclear. The purpose of this study was to review our experience and analyze our results together with similar patients in the literature to identify common characteristics and propose a management strategy.
Methods
A PubMed search was performed for articles describing patients in whom contralateral axillary drainage was identified on lymphoscintigraphy. Additionally, a chart review was performed of all patients who had lymphoscintigraphy for breast cancer at our institution.
Results
At our institution, two of 988 (0.3 %) consecutive patients were identified with contralateral axillary drainage on lymphoscintigraphy. Twenty-seven publications describing 105 patients with contralateral axillary drainage were found. This comprised our study group of 107 patients. Lymphoscintigraphy patterns varied depending on the history and type of prior surgery. A history of chest/axillary surgery was significantly associated with absence of an ipsilateral SLN (
p
< 0.05). This was observed in 84.2 % of patients with prior axillary lymph node dissection versus 33.3 % with prior SLN. Contralateral SLN biopsy was attempted in 85 patients (79.4 %); 22 (20.6 %) were positive for tumor. In 17 patients (15.9 %), the contralateral node was the only positive SLN.
Conclusions
These findings suggest that contralateral uptake on lymphoscintigraphy, though rare (0.2 %), is clinically significant and such nodes should undergo excision. Because contralateral uptake is significantly associated with prior chest/axillary surgery, routine lymphoscintigraphy should be considered in this group, as it has potential to change disease stage and management.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>23975295</pmid><doi>10.1245/s10434-013-3151-y</doi><tpages>6</tpages></addata></record> |
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| subjects | Adult Breast cancer Breast Neoplasms - diagnostic imaging Breast Neoplasms - pathology Breast Neoplasms - surgery Breast Oncology Carcinoma, Ductal, Breast - diagnostic imaging Carcinoma, Ductal, Breast - pathology Carcinoma, Ductal, Breast - surgery Carcinoma, Lobular - diagnostic imaging Carcinoma, Lobular - pathology Carcinoma, Lobular - surgery Female Follow-Up Studies Humans Lymph Nodes - diagnostic imaging Medicine Medicine & Public Health Middle Aged Neoplasm Staging Oncology Prognosis Radionuclide Imaging Radiopharmaceuticals Retrospective Studies Sentinel Lymph Node Biopsy Surgery Surgical Oncology |
| title | Management of Contralateral Axillary Sentinel Lymph Nodes Detected on Lymphoscintigraphy for Breast Cancer |
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