Breast cancer lymphoscintigraphy: Factors associated with sentinel lymph node non visualization

Vaz, Sofia; Silva, Â.; Sousa, Rita; Ferreira, Teresa; Esteves, Susana; Carvalho, Inês; Ratão, P.; Daniel, Amelia; Salgado, L.

doi:10.1016/j.remnie.2015.03.019

Cited by 2 publications

(4 citation statements)

References 12 publications

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“…Whether tumor location is a risk factor for SLN nonvisualization [3,6], is still disputable. We and other studies could not nd a signi cant effect of tumor location on SLN nonvisualization [2,4,5,7].…”

Section: Discussioncontrasting

confidence: 75%

“…These risk factors are in accordance with ndings of other studies. Increased age [2][3][4][5][6][7] and higher BMI [3][4][5][6] are well known risk factors for SLN nonvisualization on lymphoscintigraphy. It has been hypothesized that replacement of lymph nodes by fatty tissue decreases the capacity of lymph nodes to retain the radioactive colloid [13] and that increased fatty tissue in elderly patients causes decreased lymphatic ow in the breasts [14].…”

Section: Discussionmentioning

confidence: 99%

“…However, the preoperative lymphoscintigraphy may fail to visualize the SLN in some patients. In literature, reported rates of SLN nonvisualization vary between 2% and 28% [2][3][4][5][6][7]. Different patient characteristics (body mass index (BMI), age) and tumor characteristics (size, location, palpability) have been found to be associated with SLN nonvisualization [2][3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for nonvisualization of the sentinel lymph node on lymphoscintigraphy in breast cancer patients

Chahid

Qiu

Garde

et al. 2021

Preprint

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BackgroundAccurate sentinel lymph node (SLN) staging is essential for both prognosis and treatment in patients with breast cancer. However, the preoperative lymphoscintigraphy may fail to visualize the SLN in some patients. The purpose of this retrospective study was to identify risk factors associated with SLN nonvisualization on lymphoscintigraphy. For this single-center retrospective study all data of lymphoscintigraphy of SLN procedures from March 2011 to April 2021 were collected and reviewed from the Amsterdam UMC database. ResultsA total of 1886 SLN procedures were included in this study. The SLN nonvisualization rate was 25.1% on lymphoscintigraphy at 4 hours post injection. The SLN nonvisualization rate decreased to 9.4% after reinjection. Multivariable analysis showed that age ≥70 years (P<0.001; OR: 2.27; 95% CI: 1.46–3.53), BMI ≥30 kg/m2 (P=0.031; OR: 1.48; 95% CI: 1.04–2.12), and nonpalpable tumors (P=0.004; OR: 1.54; 95% CI: 1.15–2.07) were independent predictors of SLN nonvisualization. Tumor location, brand of radiopharmaceutical, injected dose and volume, experience of preparer and administrator were not associated with SLN nonvisualization. None of the patient, tumor or tracer characteristics were associated with SLN nonvisualization after radiotracer reinjection.ConclusionsThis study shows that risk factors for SLN nonvisualization in breast cancer patients during preoperative lymphoscintigraphy are age ≥70 years, BMI ≥30 kg/m2, and nonpalpable tumors. Our results support the notion that SLN lymphoscintigraphy is a very robust technique, that does not depend on the experience of the preparer or administrator of the radiotracer.

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Section: Discussioncontrasting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk factors for nonvisualization of the sentinel lymph node on lymphoscintigraphy in breast cancer patients

Chahid

Qiu

Garde

et al. 2021

Preprint

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“…We have shown that a higher age and higher BMI negatively influence SLN visualization on preoperative imaging, as is in accordance with other studies. [3][4][5] Further, we have found that nonpalpable tumors are significantly associated with SLN nonvisualization. This might be explained by the assumption that image-guided intratumoral injections will more precisely inject the radiotracer inside the tumor tissue in comparison to injections guided by palpation that will end up more often in the peritumoral tissue.…”

Section: Discussionmentioning

confidence: 63%

Sentinel lymph node nonvisualization after intratumoral radioisotope tracer injection in breast cancer is not associated with a higher nodal metastasis rate or worse outcomes

Hellingman

Veen

Wan

et al. 2018

Journal of Surgical Oncology

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Background and Objectives Preoperative lymphoscintigraphy does not always visualize a sentinel lymph node (SLN). The study aim was to investigate whether persistent nonvisualization after additional single‐photon emission computed tomography (SPECT)/CT or a second radiotracer injection in breast cancer patients is associated with nodal metastases or worse outcome due to potential understaging and consequently undertreatment. Methods Altogether 2042 consecutive SLN procedures were evaluated. All patients were clinically node‐negative, underwent axillary ultrasound and fine‐needle aspiration cytology (US/FNAC) of suspicious nodes. Lymphoscintigraphy was performed at 3 to 4 hours after intratumoral injection of 99mTc‐nanocolloid. SPECT/CT or a reinjection was performed when initial lymphoscintigraphy showed nonvisualization. Results Persistent nonvisualization was seen in 170 of 2042 procedures (8.3%). The nodal metastasis rate was 16.0% vs 18.0% for procedures with nonvisualization vs SLN visualization, respectively (P = 0.593). The regional recurrence rate of tumor‐negative SLN biopsy procedures was equal between the nonvisualization (0.7%, 11 of 1535) vs visualization (0.7%, 1 of 144) group. Median follow‐up was 48 months. Distant–metastasis free interval and overall survival was not significantly different between both groups ( P = 0.164 and 0.208, respectively). Conclusions Persistent nonvisualization after lymphoscintigraphy plus SPECT/CT or radiotracer reinjection is not associated with a higher nodal metastasis rate or worse long term outcome when preoperative US/FNAC is performed.

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Breast cancer lymphoscintigraphy: Factors associated with sentinel lymph node non visualization

Cited by 2 publications

References 12 publications

Risk factors for nonvisualization of the sentinel lymph node on lymphoscintigraphy in breast cancer patients

Risk factors for nonvisualization of the sentinel lymph node on lymphoscintigraphy in breast cancer patients

Sentinel lymph node nonvisualization after intratumoral radioisotope tracer injection in breast cancer is not associated with a higher nodal metastasis rate or worse outcomes

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