Scintigraphic visualization of an epigastric sentinel node in recurrent breast cancer after lumpectomy and postoperative radiation therapy

Renata Milardovic, Ivan Castellon, Christopher Mills, M. Erkan Altinyay, Barbara Raphael, Hussein M. Abdel-Dayem

Research output: Contribution to journalArticle

6 Scopus citations


Sentinel node imaging and biopsy have become standard procedures for staging early breast cancer. Positive sentinel lymph node (SLN) biopsy necessitates the need for axillary lymph node dissection (ALND). Failure to visualize a sentinel lymph node in recurrent breast cancer after treatment by surgery, chemotherapy, and high-dose postoperative radiation therapy is almost the case in every patient. The reason for failure to visualize the sentinel node is the fibrosis that follows high-dose radiotherapy and blocks the lymphatics preventing spread of the tumor cells to the lymph nodes. Alternative pathways for the drainage of lymph from the breast are developed in these patients. We have previously reported on the alternative pathways of lymphatics to the contralateral axilla, supraclavicular area, and also reported on the development of intramammary lymph nodes. In this report, we are presenting another alternative pathway of lymphatics to the region of the epigastrium below the lower end of the sternum.

Original languageEnglish (US)
Pages (from-to)207-208
Number of pages2
JournalClinical Nuclear Medicine
Issue number4
StatePublished - Apr 1 2006



  • Breast cancer
  • Epigastrium
  • Lymphoscintigraphy
  • Sentinel lymph node
  • Tc-99m sulfur colloid

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

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