A Practical Technique to Improve Visualization of Sentinel Nodes in the Axillary Region on Breast Lymphoscintigraphy: Medial Breast Traction by Patient

Abstract

Methods: A standard method of performing breast lymphoscintigraphy is to obtain anterior and lateral views after periareolar intradermal injection of a radiotracer. However, a sentinel lymph node may be obscured by the activity at the injection site, especially on anterior views. Also, breast tissue may cause attenuation to prevent sentinel node visualization. In cases in which a sentinel lymph node is visualized on one view but not the other view or a sentinel lymph node is either not visualized or inadequately visualized, we repeat anterior and lateral views during medial traction of the breast performed by the patient. Results: We have found the medial breast traction technique performed by the patient to be especially useful for identification of axillary sentinel nodes. Conclusion: Repeat images during medial traction of the breast by the patient is an effective technique to improve visualization of sentinel lymph nodes in the axillary region.