Location
Suwanee, GA
Start Date
6-5-2025 1:00 PM
End Date
6-5-2025 4:00 PM
Description
Background/Objective:
In recent literature, there has been a question of how to surgically manage patients with recurrent ipsilateral breast cancer due to the possibility of aberrant lymphatic drainage pattern secondary to a previous axillary lymph node dissection. The use of preoperative lymphoscintigraphy to map possible aberrant drainage patterns prior to surgery remains investigational, necessitating the need for further management guidelines.
Methods:
We identified two patients in our database with recurrent ipsilateral breast cancer and previous nodal surgery as well as lymphoscintigraphy showing focal uptake of radioactive tracer on the contralateral side.
Results:
Two patients presented with recurrent ipsilateral breast cancer. A 66-year-old female diagnosed with right breast cancer in 2008. This patient underwent right lumpectomy with axillary lymph node dissection, chemotherapy and radiation therapy. She presented in 2024 with a new diagnosis of right invasive ductal carcinoma, grade 2, ER/PR positive, HER2 negative. The second patient is a 64-year-old female diagnosed with left breast cancer in 1998. This patient underwent left lumpectomy with axillary lymph node dissection, chemotherapy and radiation therapy. She presented in 2021 with a new diagnosis of left invasive ductal carcinoma, Grade 2, ER/PR positive, HER2 negative. Both patients underwent lymphoscintigraphy with radioactive tracer showing focal uptake on the contralateral side indicating aberrant lymphatic drainage. Our findings collectively suggest that in patients with recurrent ipsilateral breast cancer and previous SLNB and axillary node dissection, using nuclear medicine lymphoscintigraphy early in the treatment course offers essential information for surgical planning.
Conclusions:
Lymphoscintigraphy performed in patients with recurrent ipsilateral breast cancer could prove to be useful in providing information essential to breast cancer management. Using this technique, aberrant lymphatic drainage and potential nodal metastasis can be identified and used to inform surgical planning. There is a need for further management guidelines in patients with aberrant lymphatic drainage to the contralateral side with previous axillary lymph node dissection and possibly even sentinel lymph node biopsy.
Embargo Period
5-28-2025
Included in
Lymphoscintigraphy use and surgical planning in patients with recurrent ipsilateral breast cancer
Suwanee, GA
Background/Objective:
In recent literature, there has been a question of how to surgically manage patients with recurrent ipsilateral breast cancer due to the possibility of aberrant lymphatic drainage pattern secondary to a previous axillary lymph node dissection. The use of preoperative lymphoscintigraphy to map possible aberrant drainage patterns prior to surgery remains investigational, necessitating the need for further management guidelines.
Methods:
We identified two patients in our database with recurrent ipsilateral breast cancer and previous nodal surgery as well as lymphoscintigraphy showing focal uptake of radioactive tracer on the contralateral side.
Results:
Two patients presented with recurrent ipsilateral breast cancer. A 66-year-old female diagnosed with right breast cancer in 2008. This patient underwent right lumpectomy with axillary lymph node dissection, chemotherapy and radiation therapy. She presented in 2024 with a new diagnosis of right invasive ductal carcinoma, grade 2, ER/PR positive, HER2 negative. The second patient is a 64-year-old female diagnosed with left breast cancer in 1998. This patient underwent left lumpectomy with axillary lymph node dissection, chemotherapy and radiation therapy. She presented in 2021 with a new diagnosis of left invasive ductal carcinoma, Grade 2, ER/PR positive, HER2 negative. Both patients underwent lymphoscintigraphy with radioactive tracer showing focal uptake on the contralateral side indicating aberrant lymphatic drainage. Our findings collectively suggest that in patients with recurrent ipsilateral breast cancer and previous SLNB and axillary node dissection, using nuclear medicine lymphoscintigraphy early in the treatment course offers essential information for surgical planning.
Conclusions:
Lymphoscintigraphy performed in patients with recurrent ipsilateral breast cancer could prove to be useful in providing information essential to breast cancer management. Using this technique, aberrant lymphatic drainage and potential nodal metastasis can be identified and used to inform surgical planning. There is a need for further management guidelines in patients with aberrant lymphatic drainage to the contralateral side with previous axillary lymph node dissection and possibly even sentinel lymph node biopsy.