Mammary lymphoscintigraphy with various radiopharmaceuticals in breast cancer

Shigeru Imoto, Kohji Murakami, Hiroshi Ikeda, Hiroyoshi Fukukita, Noriyuki Moriyama

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)


Sentinel node biopsy (SNB) in breast cancer is a promising surgical technique that avoids unnecessary axillary lymph node dissection. To optimize lymphatic mapping with radiopharmaceuticals, mammary lymphoscintigraphy with 30-50 MBq of technetium-99m-diethylenetriamine pentaacetic acid human serum albumin ((99m)Tc-HSAD), technetium-99m-human serum albumin ((99m)Tc-HSA), or technetium-99m-tin colloid ((99m)Tc-TC) were investigated in 69 cases of primary breast cancer. Dynamic early images were obtained during the first 30 or 40 minutes, and static delayed images were obtained 6 hours after tracer injection. Hot spots as sentinel lymph nodes (SLNs) appeared in 51 of 69 cases (74%): in early images in 27 cases and in delayed images in 24 cases. SLNs were visualized more frequently in 23 of the 26 cases (88%) treated with (99m)Tc-HSAD and in 21 of the 24 cases (88%) treated with (99m)Tc-HSA than in only 7 of the 19 cases (37%) treated with (99m)Tc-TC. In 26 of the 51 cases, SLNs were identified as faint spots in delayed images. There was a significant difference in the first appearance of SLNs on the lymphoscintiscan between 43 cases of dense breast parenchyma and 26 cases of fatty breast parenchyma. These results suggest that (99m)Tc-HSAD or (99m)Tc- HSA is acceptable for lymphatic mapping, but in cases which have faint spots in delayed images or fatty breast parenchyma, gamma probe-guided SNB may result in failure or misleading false-negative SLNs.

Original languageEnglish
Pages (from-to)325-329
Number of pages5
JournalAnnals of Nuclear Medicine
Issue number5
Publication statusPublished - 1999
Externally publishedYes


  • Breast cancer
  • Breast parenchyma
  • Lymphoscintigraphy
  • Sentinel lymph node

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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