Introduction: Controlateral mammaplasty is often necessary during the procedure of breast reconstruction after mastectomy.However the impact of this kind of surgery on axillary lymphatic drainage and sentinel node (SN) detection remains controversial. The American Society of Clinical Oncology (ASCO) as published a guideline in 2005 and recommended that SN biopsy should not be performed in patients with previous mammplasty or axillary surgery.However, because of insufficient evidence and lack of scientific studies, mammaplasty cannot be considered as an absolute contraindication for SN biopsy procedure. Therefore, the same panellists of the ASCO guideline suggested that a preliminary lymphoscintigraphy (LSG) could be done when considering a SN biopsy in patients with previous mammaplasty, with the objective of verifying the integrity of the mammary gland and axillary nodes.The aim of our study was to evaluate the lymphatic patterns and SN detection rates after mammaplasty by using lymphoSPECT-CT (LS).Methods: ten patients who underwent mammaplasty were evaluated by LSG immediately after intradermal periareolar injections of 99mTc -labelled sulphur colloid (NanoCIS*) at two time points: before mammaplasty (Pre-LS) and between 40 to 60 days after mammaplasty (Post- LS).Results: all breasts drained primarily to the axillary SN. The binomial test did not show statistical difference in lymphatic drainage patterns between Pre-LSG and Post-LSG.The average number of hot SN was 1.28 in Pre-LS, 1.14 in Post-LS.The localisation of hot SN was evaluated by:- antero-posterior distance was estimated in centimeter from SN region to dorsal vertebrae spine center-SN's coronal position was compared to grill rib.The preservation of axillary lymphatic drainage after mammaplasty was allowed for SN detection in all studied breasts and the localisation of the sentinel node was the same after surgery than before.Conclusion: after evaluating the impact of the previous mammaplasty surgery on the accuracy of SLN biopsy, we observed that this kind of surgery did not significantly affects the accuracy of lymphatic mapping and that it may be possible to propose sentinel node biopsy after mammaplasty.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1028.