Management of Contralateral Axillary Sentinel Lymph Nodes Detected on Lymphoscintigraphy for Breast Cancer

Abstract

These findings suggest that contralateral uptake on lymphoscintigraphy, though rare (0.2 %), is clinically significant and such nodes should undergo excision. Because contralateral uptake is significantly associated with prior chest/axillary surgery, routine lymphoscintigraphy should be considered in this group, as it has potential to change disease stage and management.

Right breast cancer with contralateral left axillary sentinel lymph node detected through lymphoscintigraphy

“…In about 25% of breast cancer cases in which SLN mapping was performed, lymphatic drainage was found in the extra-axillary site rather than is the most common site, the ipsilateral axillary lymph node. 6 Histopathological assessment and evaluation of the contralateral axillary SLN if detected in a patient with breast cancer is essential as it may be the primary site of lymphatic drainage and further treatment can be tailored based on the results. A positive contralateral axillary lymph node is considered distant metastasis (M1).…”

“…However, if asymptomatic metastasis is discovered after examining the SLN microscopically then it is considered primary node staged as pN1. 6 Contralateral axillary lymph node metastases accounts for only 3.5-6% breast cancer. 7 Alteration of the lymphatic drainage from ipsilateral axilla to extra-axillary sites is expected after breast or axillary surgery, as in our case, and most commonly to the internal mammary chain followed by intramammary, subclavicuar, interpectoral and supraclavicular lymph nodes, unlike our case, where the SLN found to be in the contra lateral axilla.…”

“…They are primarily located in the ipsilateral internal mammary chain, intra-mammary nodes, and, rarely in the contralateral axilla. 6 We report a case of a patient with breast cancer and a contralateral SLN. Such a case was encountered for the first time in our hospital.…”

Contralateral lymph node recurrence in breast cancer: Regional event rather than distant metastatic disease. A systematic review of the literature

“…Drainage to the contralateral axilla is more rare, occurring in 0e2% at initial diagnosis. 34,35 However, after previous surgery or radiotherapy of the breast or axilla, aberrant drainage patterns are more common. Overall, drainage outside of the ipsilateral axilla is described in 18e70% after previous surgery or radiotherapy for breast cancer.…”

Treatment of Breast Cancer With Metastatic Contralateral Axillary Lymph Nodes: Case Report and Literature Review

“…Исследование I.M. Lizarraga et al [3] включило данные о двух пациентках, наблюдаемых в клинике авторов, а также 105 больных, описанных в 27 публикациях с января 2000 г. по декабрь 2012 г., метастаз у которых в КПЛУ был идентифицирован при лимфосцинтиграфии. Чаще всего метастазы наблюдались у женщин с предшествующей лимфодиссекцией (84,2 %).…”