The Use of Lymphoscintigraphy to Localise the Sentinel Lymph Node/S

Greater public awareness and early screening has led to patients presenting with smaller breast tumours. Knowledge about axillary node metastases is essential to accurately stage early breast carcinoma and plays an important role in determining prognosis and post-operative management. The standard method of evaluating the axilla has been a complete axillary lymph node dissection. This can result in significant patient morbidity, particularly lymphoedema and neurological disturbances in the ipsilateral arm. Sentinel lymph node (SLN) biopsy is being used increasingly for staging early breast carcinoma in place of complete axillary lymph node dissection. The optimal method to identify the SLN and has not been clearly elucidated in the literature. A number of techniques have been proposed for identifying SLN/s. The main debate centres on whether to use a blue dye or radiopharmaceutical method either singly or in combination. The different injection techniques described in the literature reliably identify the "true" SLN/s in the axilla.