Semi-quantitative lympho-scintigraphic approach: Preliminary results of early detection of breast-cancer related lymphedema

1448 Objectives The aim is to evaluate the efficacy of semi-quantitative lymphoscintigraphy to early diagnose lymphedema after axillary dissection in patients with breast cancer. Methods Fifty-five consecutive patients underwent to semi-quantitative lymphoscintigraphy at 1, 6 and 12 months after axillary dissection and every 6 months during follow up. After subcutaneous injection of 99mTc-nanocolloid (37 MBq, 0.2ml) into the dorsum of both hands images of the arms and axillary was acquired after 20, 90, and 180 minutes. A comparative and semi-quantitative analysis of scintigraphic images was correlated with the clinical evaluation. Results Scintigraphic data obtained 1 months after axillary dissection showed the presence of lymphatic stasis in 90% of the cases associated with normal clinical examination. After 6 months 70% of patients showed lymphatic stasis and/or lymphatic slowdown, but in the majority of cases clinical examination remained negative. After 12 months scintigraphic findings showed in 90% of patients which underwent to early therapy based on nuclear medicine data, an improvement of lymphedema or stable edema. In the remaining cases the following scintigraphic evaluations showed clinical worsening associated with appearance of lymphedema. Conclusions The lymphoscintigraphy had high diagnostic yield, allowing early treatment of lymphedema. Semi-quantitative scintigraphic evaluation is important for recognition of the early (latent) stages of the disease. The persistence of pathological scintigraphic findings after 12 months from axillary dissection, may be considered as a prognostic marker to develop severe/irreversible lymphedema. Research Support Study is partially supported by a grant from the Min. of Health (5 per mille), Italian Association of Cancer (AIRC) and Fondazione Umberto Veronesi.