First experience of lymphoscintigraphy use in early stages of breast cancer

Aim. To evaluate efficacy of radioisotopic methods in detection of metastatic involvement of sentinel lymph nodes for choosing further theurapeutic tactics.

Methods. The study group included 23 females with confirmed breast cancer. Sentinel lymph nodes were detected by isotope 99mTc Nanocolloid and blue dye in General Electric gamma camera (USA).

Results. In all cases patients’ age was 45 to 60 years. In 16 (69.5%) cases the tumor size was below 5 cm which corresponded to clinical stage 2, in other 7 (30.5%) patients the tumor size was below 2 cm. Positive results with the use of lymphoscintigraphy were revealed in 6 (26%) cases, all results were morphologically confirmed straight after lymph node removal. In 5 (83%) cases metastatic involvement of the node was observed in stage 2 cancer. Such patients were immediately referred to radical mastectomy with radical lymph node dissection. In other cases pathological accumulation of a radiopharmaceutical was not observed. Only in one case after removal of such node its metastatic involvement was confirmed histologically. So the frequency of false negative results was 4.3%. Respectively, status of sentinel lymph nodes in breast cancer reflects the status of lymphatic collector with 95.7% accuracy.

Conclusion. The biopsy results demonstrated high diagnostic value of lymphoscintigraphy for detection of breast cancer metastases to sentinel lymph nodes (sensitivity 86%, specificity 100%): the method can be successfully used in early stages of breast cancer and also in case of negative results of conventional diagnostic methods (ultrasound, roentgen mammography).