Authors: Thomas W Barber Michael S Hofman Rodney J Hicks
Publish Date: 2010/09/07
Volume: 37, Issue: 11, Pages: 2203-2203
Abstract
A 43yearold woman underwent sentinel lymph node localisation prior to a left mastectomy and sentinel node biopsy for recurrent multifocal leftsided breast cancer Previous treatment included a wide local excision and left axillary nodal clearance 15 months ago Following one periareolar intradermal injection of 15 MBq of 99mTcantimony colloid in the upper inner quadrant of the left breast dynamic planar imaging failed to identify a sentinel node SPECT/CT imaging demonstrated a lymphatic channel extending from the left subpectoral region through the lingula of the left lung into the mediastinum posterior to the pulmonary trunk and terminating in the subcarinal nodal station arrow This unusual pattern of breast lymphatic drainage via the pulmonary lymphatic system is attributed to opening of collateral lymphatic channels following the previous left axillary nodal clearance A left internal mammary sentinel lymph node arrowhead was also demonstrated and confirmed intraoperatively
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