Lymphatic drainage after prior breast surgery

Rationale:

Like in primary breast cancer, prognosis in recurrent breast cancer is correlated with regional lymph node status. Therefore, axillary staging may be warranted in patients with recurrent disease and intact axillary nodes, although this has not been described in guidelines yet. The lymphatic drainage pathways in the breast and/or axilla could have been changed due to prior surgery and/or radiotherapy. These aberrant drainage pathways could be detected with lymphatic mapping and sentinel node biopsy (SNB), leading to a more accurate staging.



Objective:

To assess the technical feasibility of lymphoscintigraphy after prior breast surgery (PBS). A second goal is to investigate whether or not previous breast surgery (with or without radiotherapy) significantly changes the lymphatic drainage pathways of the breast.



Study design:

A prospective cohort study.

The intention is to include 50 women above 18 years who underwent PBS in the setting of breastcancer between 01/01/2002 and 31/12/2007. From all included patients a lymphoscintigram will be made which will be compared with pre-operative lymphoscintigram in order to detect changes in lymphatic drainage pathways.



Main study parameters/endpoints:

To assess the technical feasibility of lymphatic mapping in patients who underwent PBS for primary breast cancer. Identification of lymphatic drainage pathways in patients who received PBS.

N/A

We will evaluate the lymphatic drainage at 1, 3, or 5 years after surgery and/or completement of radiotherapy.



The actual lymphoscintigram will be made at +/- 2 hours after injection of radioactive colloid.

Injection of radioactive colloid