The Lymphatic Anatomy of the Breast and Its Implications for Sentinel Lymph Node Biopsy: A Human Cadaver Study

Excerpt

There is fierce debate over the best site to administer tracer fluids for sentinel lymph node biopsy in patients with breast cancer. The superficial intradermal, subdermal, periareolar, and subareolar injection techniques have several advantages over a deeper injection at the primary tumor site. The superficial techniques are easier to perform and the tracers are quickly taken up by the lymphatics. Early lymphoscintigraphy images more often visualize the lymphatic channels that help to distinguish first-tier nodes from higher-tier nodes. Tracer uptake in the sentinel node is higher, facilitating its retrieval with the gamma ray detection probe.1 The blue lymphatic duct that guides the surgeon to the sentinel node in the axilla is also more easily identified. …