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Lymphoscintigraphy

It's a crazy looking word, but one that I'm finding people are very misinformed about. Lymphoscintigraphy is a nuclear medicine exam involving the injection of a radioactive isotope. The test is done to localize the sentinel lymph node and map the flow of your lymphatic system.


For breast cancer patients this exam is either performed the day before or the day of surgery. Three to four incredibly superficial injections of a very tiny amount of liquid will be introduced through the smallest needle I've ever seen around your areola of the breast cancer breast. The injections do not go directly in your nipple.


I repeat - the injections do NOT go directly in your nipple.


You get these injected radiopharmaceutical doses and then lay on the imaging table for 30 to 45 minutes while the nuclear medicine technologist maps where the isotope goes in your body. It will collect in the first lymph node(s) draining from the breast. This test only shows where the lymph nodes are so that your surgeon test them to determine if your cancer has spread outside of the breast.


The scan itself is not therapeutic nor is it diagnostic. If you inject and random Jon or Jane, Sally or Tim the same process will occur. The lymphatic system will detect the foreign material in your body and begin to filter it out. Lymphoscintigraphy is designed to assist your surgeon in knowing where to find your lymph nodes.


Most of us will find that the sentinel lymph node lives somewhere in the armpit area, but we're all unique and sometimes it may actually be closer to your midline or in your breast. Personally, I don't want my surgeon cutting up my armpit without a roadmap to where the target is, especially if there is a chance that my sentinel lymph node is somewhere else.


The imaging acquired during the scan is actually kind of pretty - some glowing dots on the screen, but not all that exciting beyond that.


You are likely to experience each injection slightly differently. Some people feel absolutely nothing, others report a slight stingy sensation - either way each injection only lasts about 3-5 seconds and then you don't feel it at all anymore. So if you need 4, that's only a total of 20 seconds of discomfort.


Hope this clears up some misconceptions. We don't want you to be fearful of a test that will help stage, diagnose and treat your cancer. Good luck and heal quickly.


photo credit: 🇸🇮 Janko Ferlič, free to use under the Unsplash License.


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