Preoperative radionuclide lymphangiography and sentinel node localization with radionuclide techniques. Advantages and ambiguous aspects

Axillary lymph node status is one of the most important prognostic factors for patients with melanoma and early breast cancer. Axillary lymph node dissection is an important part of the surgical treatment of breast cancer. As an alternative to axillary node dissection was proposed the sentinel lymph node detection (SLND). This technique was initially described for detecting occult lymph node metastasis in patients with melanoma and recently is used for breast cancer patients. Nowadays the radioisotopique techniques, including the lymphoscintigraphy and the intraoperative detection of SN, have received attention as a possible alternative to axillary lymph nodes dissection because of the clinical value of SN in malignancies and the development of technical equipment. We review the different techniques of preoperative lymphoscintigraphy and intraoperative detection of SN, including the radioisotopique tracers, timing and site of injection and the clinical value of both methods in patients with early breast cancer.