Prominent Lymphatic Channels Simulating Sentinel Nodes: The Use of Standing and Delayed Views in Delineating the True Number and Position of Nodes and the Implications for Further Morbidity Reduction

A 52-year-old woman with breast carcinoma underwent lymphoscintigraphy. Initial and supine views at 70 minutes showed 3 grouped foci of similar intensity in the left axilla that appeared to represent nodes. Standing views with multiple arm positions revealed prominent lymphatic channels of a unique geometry that on supine views simulated sentinel nodes in 2 of the 3 grouped foci. Views at 4 hours confirmed the findings on early standing views. These findings illustrate the use of early standing views in conveying to the surgeon the true number of sentinel nodes and their potential role for further morbidity reduction.