Abstract
Background: The current standard for obtaining accurate sentinel lymph node SLN mapping is intraparenchymal lymphophilic dye/radiocolloid injection close to the breast tumor. We hypothesized that common lymphatic trunks drain both a large volume of breast parenchyma and skin and that intradermal or intraparenchymal routes flow to the same axillary node.
Methods:99mTc-labeled filtered sulfur colloid was injected intradermally directly over the breast tumor in 119 patients. Blue dye was injected intraparenchymally in the same quadrant as the primary tumor concordant quadrant in 66 and in a discordant quadrant in 53 patients. During axillary exploration, both blue and gamma-emitting hot nodes were found. End points were SLNs that were hot and blue, either the same node or different nodes.
Results: In 62 93.9% of 66 of concordant quadrant and in 49 92.5% of 53 of discordant quadrant patients, the same SLN was both hot and blue P = .99; Fisher’s exact test. In eight cases in which two distinct nodes were blue and not hot and hot but not blue, the lymph nodes were very close to each other.
Conclusions: The dermal and parenchymal lymphatics of the breast seemed to drain to the same axillary lymph nodes. Lymph from the entire breast seemed to drain through a small number of lymphatic trunks to one or two lymph nodes.
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Presented at the 54th Annual Meeting of the Society of Surgical Oncology, Washington, DC, from March 15–18, 2001.
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Nathanson, S.D., Wachna, D.L., Gilman, D. et al. Pathways of Lymphatic Drainage From the Breast. Ann Surg Oncol 8, 837–843 (2001). https://doi.org/10.1007/s10434-001-0837-3
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DOI: https://doi.org/10.1007/s10434-001-0837-3