Role of lymphoscintigraphy in sentinel lymph node biopsy in breast cancer patients

Objective To explore the role of lymphoscintigraphy in sentinel lymph node biopsy(SLNB)in breast cancer patients.Methods We retrospectively analyzed 716 consecutive breast cancer patients who received preoperative lymphoscintigraphy before SLNB in our database.Results The success rate of sentinel lymph node biopsy(SLNB)was 98.2%(703/716).The false negative rate of SLNB was 16.0%(15/94).Among all the patients,sentinel lymph nodes(SLN)were well imaged by lymphoscintigraphy in 86.6% patients,and SLNs were found at extra-axilla in 36 patients.The visualization of SLN in lymphoscintigraphy was not associated with histopathologic type,the location and stage of primary tumor and time interval from injection of radiocolliod to surgery.However,the negative lymphoscintigraphy results were associated with excision biopsy before injection of radiocolliod and axillary node metastases.Failure of surgical identification of axillary SLN was associated with the imaging of hot spot by lymphoscintigraphy.There was no significant difference in the false negative rate between patients who had axillary hot spot in lymphoscintigram and those who did not have(P=0.731).Conclusions Visualization of SLN in preoperative lymphoscintigraphy predicts the successful SLN identification.Moreover,preoperative lymphoscintigraphy is helpful in identification of extra-axillary sentinel nodes.However,it is not necessary in sentinel lymph nodes biopsy in breast cancer.