When someone is diagnosed with breast cancer, many imaging studies and tests may need to be done to fully diagnose the disease and determine the stage of the cancer. One of these tests is lymphoscintigraphy.

Lymphoscintigraphy is also called lymph node mapping. It is an imaging procedure that finds the location of lymph nodes and the pattern of lymph drainage. This helps to determine the location of the sentinel lymph node, which is the lymph node closest to a breast cancer tumor. This lymph node often needs to be biopsied to see if any cancerous cells are present.

This article will review the purpose of the tests, the risks associated with it, how it is performed, and what the results can mean.

Purpose of Test

Lymphoscintigraphy is frequently used for people with early breast cancer since studies show that it is very effective. While it has also been used to identify other conditions, it has been proven especially useful in breast cancer.

In the case of breast cancer, the sentinel lymph nodes are the first to show evidence of cancer cells that have spread from the breast. Lymphoscintigraphy can identify these lymph nodes and detect which ones are free from cancer. This is very important in determining the type of treatment needed for breast cancer.

Risks and Contraindications

The risks associated with lymphoscintigraphy are typically small.

This is a nuclear medicine procedure, which means you’ll be exposed to a very small amount of radiation. The amount of radiation exposure during lymphoscintigraphy is about the same amount that someone would get from exposure to natural radiation in five weeks.

The injection may cause redness and slight pain, which usually goes away quickly.

Allergic reactions to the radiotracer that will be injected are rare. If they do occur, they are usually mild. Still, make sure you let your healthcare provider and the technician know if you’ve ever had an allergic reaction or other problem with a similar test.

Lymphoscintigraphy isn’t recommended for everyone with breast cancer. Contraindications include:

  • Pregnancy and breastfeeding
  • Inflammatory breast cancer
  • Breast tumors larger than 5 centimeters
  • Multiple tumors in the breast
  • Ductal carcinoma in situ (DCIS), a condition in which cancer cells grow inside the breast
  • High body mass index (BMI)
  • Old age

Before the Test

Be sure to arrive early enough to check in before your appointment time. It’s a good idea to use the bathroom first, too.

Timing

The length of the test varies from about 30 minutes to two hours or more based on several factors. Be sure to ask ahead of time how long yours is expected to take.

Location

You probably will undergo a lymphoscintigraphy in an outpatient or clinic setting, but some hospitals offer it as well. 

What to Wear

Depending on where you are going for this test, you may either be asked to wear a medical gown or just remain in your own clothes. It’s suggested that you wear comfortable clothing without metal snaps or buttons. Before the procedure, remove any jewelry or accessories that have any metal in them.

Food and Drink

You shouldn’t have to restrict food and drink before or after lymphoscintigraphy.

Cost and Health Insurance

If you have health insurance, check with your carrier to see whether lymphoscintigraphy will be covered and how much you’ll need to pay out of pocket. Also, check on whether the facility where it will be performed is covered.

Your healthcare provider’s office and the facility should be able to provide cost information for you.

What to Bring

Be sure you have your insurance card and any paperwork your healthcare provider may have given you.

During the Test

Once you’re called back, you’ll be given time to change into a gown (if necessary). You may be asked to confirm information such as your name, date of birth, and the test you’re scheduled for. A nurse will get you prepared and then a healthcare provider or technologist will perform the procedure.

Pre-Test

You will be asked to lie down on an examination table. Your nurse may insert an intravenous tube (IV) into your arm, depending on your needs. The necessary radioactive material will be given, potentially through multiple injections around the tumor or areola.

Other than the needle and IV placement, the lymphoscintigraphy is completely painless. After the injection, you may experience a cooling sensation, but it should not be uncomfortable.

Throughout the Test

A specialized camera that detects the radiotracer(s) will take images of your breast. Depending on the clinic, you may be asked to change your position in order to get images of different areas.

The most difficult part of the screening is that you must remain still while the images are being taken. The better you follow the instructions about when not to move, the quicker the process will go.

Post-Test

Once the test is done, you may be asked to wait while the images are reviewed to make sure everything came out clear enough. If not, you may need to redo some of them. Otherwise, you can get dressed and leave.

After the Test

You shouldn’t have any lingering side effects to manage and can usually return to your normal routine right away. In rare cases, your healthcare provider may recommend rest afterward. They will advise you about this before you leave.

Interpreting Results

A radiologist or healthcare provider specializing in nuclear medicine will look at the images and send a report to your oncologist. Your healthcare provider’s office should contact you about the results and whether any follow-up is necessary.

It is suggested that you drink more water than usual to help your body flush out the radioactive materials.

Follow-Up

The information from the lymphoscintigraphy will help your healthcare provider determine how extensive your surgery needs to be. Make sure you understand the results and what they mean for you. Ask questions if anything isn’t clear.

Summary

Lymphoscintigraphy is a common procedure used to help stage breast cancer. During this test, a special dye is injected into the breast tissue. A special machine then looks to see how the dye travels into nearby lymph nodes, to help find the first lymph node that leaves the breast. This lymph node can then be checked to see if any cancer cells are present.

A Word From Verywell

Because this test carries a minimal risk for most people and can prevent surgery you may not need, it’s a common recommendation. You may be getting tired of medical tests and scans by this point, but know that the information gained through lymphoscintigraphy often can’t be obtained in any other way—and it could save you unnecessary surgery and the pain of recovery.

Frequently Asked Questions

  • How painful is a lymphoscintigraphy?
  • There can be some discomfort associated with lymphoscintigraphy, as a needle is used to inject the dye into the breast tissue. Otherwise, the rest of the procedure is painless.
  • Is a lymphoscintigraphy safe?
  • Yes, lymphoscintigraphy is a safe procedure. The test does involve exposure to a small amount of radiation. This amount is similar to how much radiation one would experience naturally from the environment in approximately five weeks.

There can be some discomfort associated with lymphoscintigraphy, as a needle is used to inject the dye into the breast tissue. Otherwise, the rest of the procedure is painless.

Yes, lymphoscintigraphy is a safe procedure. The test does involve exposure to a small amount of radiation. This amount is similar to how much radiation one would experience naturally from the environment in approximately five weeks.