Lymphoscintigraphic SPECT/CT—Contralateral Axillary Sentinel Lymph Node Drainage in Breast Cancer

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A 58-year-old woman with previous right breast carcinoma treated with lumpectomy, right axillary clearance, chemo-radiotherapy, and adjuvant hormonal therapy underwent a lymphoscintigraphy for a new right breast lesion. On planar images, an alternate route of lymphatic drainage was observed to the right internal mammary chain and the left axilla. A chest SPECT/CT was performed to confirm the location of the sentinel nodes. The patient underwent a right mastectomy and left axillary sentinel lymph node biopsy, which showed no evidence of lymphovascular invasion. Combining planar imaging and SPECT/CT techniques can accurately identify sentinel lymph nodes at their new unpredicted location.

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