Right breast cancer with contralateral left axillary sentinel lymph node detected through lymphoscintigraphy


  • Yousif Salem Department of General Surgery, King Hamad University Hospital, Busaiteen, Kingdom of Bahrain
  • Sara Alkhaja Department of Obstetrics and Gynaecology, King Hamad University Hospital, Busaiteen, Kingdom of Bahrain
  • Noof Alshaibani Department of General Surgery, King Hamad University Hospital, Busaiteen, Kingdom of Bahrain
  • Salwa Abd El Gaid Department of Nuclear Medicine, King Hamad University Hospital, Busaiteen, Kingdom of Bahrain




Breast cancer, Sentinel lymph node, Axillary clearance


Altered contralateral axillary drainage is extremely rare after curative breast cancer treatment. We present a case of a 64 year-old women, with a past history of right breast invasive ductal carcinoma managed surgically by lumpectomy and right axillary lymph node dissection 20 years ago. She presented with recurrent right breast cancer and was scheduled to undergo right mastectomy along with sentinel lymph node biopsy. Technetium-99m nano colloid sentinel lymphoscintigraphy performed on the day of surgery showed sentinel lymph node on the contralateral left axilla. This case report aims to discuss the presentation of such uncommon contralateral sentinel axillary lymph nodes in patients with breast cancer and highlight the importance of considering the lymphatic obliteration after ipsilateral axillary lymph node clearance.


Ghoncheh M, Pournamdar Z, Salehiniya H. Incidence and mortality and epidemiology of breast cancer in the world. Asian Pac J Cancer Prev. 2016;17(3):43-6.

Ayaz S, Gultekin SS, Ayaz UY, Dilli A. Initial fludeoxyglucose (18F) positron emission tomography-computed tomography (FDG-PET/CT) imaging of breast cancer - correlations with the primary tumour and locoregional metastases. Pol J Radiol. 2017;82:9-16.

Langer I, Guller U, Berclaz G, Koechli OR, Schaer G, Fehr MK, et al. Morbidity of sentinel lymph node biopsy (SLN) alone versus SLN and completion axillary lymph node dissection after breast cancer surgery: a prospective Swiss multicenter study on 659 patients. Ann Surg. 2007;245:452-61.

Vicente DA, Henry LR, Hahm G, Soballe PW, Smart D. Axillary sentinel lymph node biopsy after mastectomy: a case report. World J Surg Oncol. 2010;8:59.

Vural G, Sahiner I, Demirtas S, Efeturk H, Demirel BB. Sentinel lymph node detection in contralateral axilla at initial presentation of a breast cancer patient: case report. Mol Imaging Radionucl Ther. 2015;24:90-3.

Lizarraga IM, Scott-Conner CE, Muzahir S, Weigel RJ, Graham MM, Sugg SL. The management of contralateral axillary sentinel lymph nodes detected by lymphoscintigraphy in a patient of breast cancer that had never undergone breast-related medical treatment. Clin Invest (Lond.). 2017;7(1):17-24.

Son YG, Kim WW, Kim KH, Kim JS. Is it contralateral axillary metastasis or occult breast cancer?. A confusing case report. Case Reports Oncol. 2015;8(3):498-502.

Boughey JC, Ross MI, Babiera GV, Bedrosian I, Feig BW, Hwang RF, et al. Sentinel lymph node surgery in locally recurrent breast cancer. Clin Breast Cancer. 2006;7:248-53.

Roumen RM, Kuijt GP, Liem IH. Lymphatic mapping and sentinel node harvesting in patients with recurrent breast cancer. Eur J Surg Oncol. 2006;32:1076-81.






Case Reports