Lymphatic Drainage of the Breast Demonstrated by Vital Dye Staining and Radiography

Halsell, John T.; Smith, J. F.; Bentlage, Charles R.; Park, Oakley K.; Humphreys, James W.

doi:10.1097/00000658-196508000-00008

Cited by 69 publications

(20 citation statements)

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“…The functional lymphatic anatomical basis for this hypothesis relies on the breast lymph flow concept proposed by Grant et al in 1953 [23] and Halsell et al in 1963 [24]. Using vital dye staining and radiography, they showed that all lymph channels of the breast parenchyma and skin communicate in the subareolar lymph plexus; from there, drainage to the axillary or parasternal lymph nodes is accomplished [23,24]. In 2000, Borgstein et al confirmed these results, stating that "the breast functions as a single biological unit, and the preferential lymph drainage pathway from all quadrants is essentially towards the same axillary (sentinel) lymph nodes" [8].…”

Section: Discussionmentioning

confidence: 99%

Peritumoural versus subareolar administration of technetium-99m nanocolloid for sentinel lymph node detection in breast cancer: preliminary results of a prospective intra-individual comparative study

Maza

Valencia

Geworski

et al. 2003

Eur J Nucl Med Mol Imaging

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The scintigraphic detection of sentinel lymph nodes (SNs) in early-stage breast cancer is a widely accepted diagnostic method. However, which radiotracer administration mode should be used is still controversial. This prospective study aimed to intra-individually compare the detection rates obtained after peritumoural versus subareolar injection with regard to SN number and localisation. Fifty-one women (age, 32-76 years) with breast cancer were investigated on two consecutive days. On day 1, 140-400 MBq technetium-99m nanocolloid was injected along the peripheral tumour margins. Static lymphoscintigrams of the axilla, thorax and neck were taken in various views 1 and 19 h p.i. On day 2, 10 MBq (99m)Tc-nanocolloid was injected subareolarly in the clock position of the tumour and dynamic and static scans were performed immediately. Thereafter, 30 MBq (99m)Tc-nanocolloid was administered peri-subareolarly and lymphoscintigrams were acquired in a dynamic and static manner. In 49/51 women, the different injection techniques disclosed the identical number and location of SNs in the axilla. In seven patients, the peritumoural injection detected additional SNs in the parasternal group. Axillary SNs were detected as early as 2-15 min following subareolar injection, both in the clock position and peri-subareolarly, as compared with about 1 h after peritumoural administration. Sixteen patients showed at least one tumour-positive SN, and nine also had tumour-positive non-SNs. One patient with a tumour-negative SN, visualised concordantly by both subareolar and peritumoural administration, demonstrated two metastatic non-SNs, yielding a false-negative rate of 5.9%. In conclusion, a simple subareolar injection in the clock position is sufficient for SN detection in breast cancer, if it is accepted that parasternal lymph node detection has no therapeutic consequences.

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Section: Discussionmentioning

confidence: 99%

Peritumoural versus subareolar administration of technetium-99m nanocolloid for sentinel lymph node detection in breast cancer: preliminary results of a prospective intra-individual comparative study

Maza

Valencia

Geworski

et al. 2003

Eur J Nucl Med Mol Imaging

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“…Breast carcinomas with intraMLN metastases are considered to be stage II disease, even in the absence of axillary lymph node involvement. Early anatomic observations suggest that the superficial and deep lymphatics of the breast drain centripetally to the subareolar plexus, then to the axilla [2,3], although lymphoscintigraphic studies show no preferential flow towards the subareolar plexus [4,5]. The deep lymphatics arise from the breast lobes, run within the breast parenchyma, leave the retro-mammary space, and pass through the pectoral and intercostal muscles to reach the internal mammary chain [6].…”

Section: Discussionmentioning

confidence: 99%

Isolated retromammary lymph node metastasis of breast cancer without axillary lymph node involvement: a case report with a false-negative sentinel lymph node biopsy

et al. 2009

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A 54-year-old woman visited our hospital with a palpable tumor in her left breast, which was diagnosed as invasive ductal carcinoma. Breast-conserving surgery was performed, in association with a sentinel lymph node (SLN) biopsy and back-up dissection of the axillary lymph nodes. One dyed axillary lymph node with high radioactivity was defined as an SLN, and intraoperative frozen-section analysis of the SLN was negative for metastasis. The final pathological diagnosis of the tumor was invasive ductal carcinoma, and one small lymph node, located in the retromammary space, just under the tumor, was positive for metastasis. The backup axillary lymph nodes were not metastatic. This patient was diagnosed false-negative by SLN biopsy, despite being positive for retroMLN metastasis. It should be recognized that retroMLNs are difficult to detect preoperatively, or intra-operatively, using dye or radiocolloid, if they are located in the post-tumoral retro-mammary space. RetroMLNs may be a pitfall in SLN biopsies.

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“…In 1965, Dr. Halsell described the results and published ''Lymphatic drainage of the breast demonstrated by vital dye staining and radiography'' [10]. Selective filling of a limited number of trunks were identified and considerable variability was noted between different patients.…”

Section: The Pastmentioning

confidence: 99%

Sentinel lymph node biopsy for breast cancer

Sato

Shigenaga

Ueda

et al. 2007

Journal of Surgical Oncology

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This manuscript is a brief discussion of the developments of the technology and concepts that led to modern procedures of radiotracer guided surgery of sentinel nodes (SNs) for breast cancer. The past section highlights some of the contributions by key persons involved with SN methods. The present section describes the magnitude of types of published material to date. The future section describes the major international trials and some important technical challenges yet to be solved.

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Lymphatic Drainage of the Breast Demonstrated by Vital Dye Staining and Radiography

Cited by 69 publications

References 0 publications

Peritumoural versus subareolar administration of technetium-99m nanocolloid for sentinel lymph node detection in breast cancer: preliminary results of a prospective intra-individual comparative study

Peritumoural versus subareolar administration of technetium-99m nanocolloid for sentinel lymph node detection in breast cancer: preliminary results of a prospective intra-individual comparative study

Isolated retromammary lymph node metastasis of breast cancer without axillary lymph node involvement: a case report with a false-negative sentinel lymph node biopsy

Sentinel lymph node biopsy for breast cancer

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