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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 5/2006

01-05-2006

A Further Validation of Subareolar Injection Technique for Breast Sentinel Lymph Node Biopsy

Authors: Giovanni D’Eredita, MD, Carmela Giardina, MD, Angela Maria Guerrieri, MD, Tommaso Berardi, MD

Published in: Annals of Surgical Oncology | Issue 5/2006

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Abstract

Background

In this study we performed subdermal injection of 99mTc-labeled albumin combined with subareolar (SA) injection of blue dye, and we compared this technique with two techniques previously used in terms of the success of sentinel lymph node (SLN) identification, false-negative (FN) rate, and the overall accuracy and sensitivity of the three procedures. In all patients we performed a complete axillary lymph node dissection.

Methods

From January 1999 to September 2004, a total of 195 patients with localized breast cancer were treated. Patients were subdivided into three groups. In patients in group 1 (n = 115; January 1999 to December 2001), lymphoscintigraphy together with injection of vital dye was performed; in group 2 (n = 40; January to October 2002), SA injection of blue dye alone was performed; and in group 3 (n = 40; November 2002 to September 2004), SA injection of blue dye and subdermal injection of radioisotope was performed.

Results

The success rate of identifying an SLN by a combination of the two techniques was 95% in group 1 and 100% in group 3. The FN rate was 9% in group 1 and 0% in groups 2 and 3. The overall accuracy of lymphatic mapping was 97% in group 1 and 100% in groups 2 and 3. Sensitivity was 91% in group 1 and 100% in groups 2 and 3.

Conclusions

This study of SA injection for SLN biopsy using dual tracers demonstrates a high SLN identification rate and an absent FN rate. We propose that injection into the SA plexus is the optimal way to perform lymphatic mapping of the breast. This technique seems to be feasible even in patients with multicentric cancers.
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Metadata
Title
A Further Validation of Subareolar Injection Technique for Breast Sentinel Lymph Node Biopsy
Authors
Giovanni D’Eredita, MD
Carmela Giardina, MD
Angela Maria Guerrieri, MD
Tommaso Berardi, MD
Publication date
01-05-2006
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 5/2006
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/ASO.2006.04.027

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