Detection of contralateral axillary sentinel lymph node by lymphoscintigraphy in breast cancer: Prognostic implications

The role of nuclear medicine in the detection of sentinel lymph nodes (SLNs) in primary breast cancer is very useful to determine regional lymphatic drainage from the affected breast, mainly its anatomical and/or tumoral individual variability and to determine the initial tumor stage.

We present the case of an infiltrating ductal carcinoma of the breast (T2) in the junction of the inner quadrants of the right breast studied by lymphoscintigraphy and gamma probe detection. Three nonmetastatic sentinel lymph nodes were found with the selective lymphadenectomy: two in the ipsilateral axilla and one in the contralateral axilla.

The lymphoscintigraphic finding of the axillary sentinel lymph node contralateral to the affected breast demonstrates the individual anatomical variability which may be found in mammary drainage and emphasizes the importance of nuclear medicine imaging techniques in the detection of such nodes, generating new prognostic approaches with impact on therapeutic measures and patient follow-up.