Related Experiment Videos
Will subareolar injection be a standard technique for sentinel lymph node biopsy?
Kazuya Yoshida1, Naohito Yamamoto, Nobuhiro Imanaka
1Division of Breast Surgery, Chiba Cancer Center, 666-2 Nitona-Cho, Chuo-ku, Chiba City, Chiba 260-8717, Japan.
Breast Cancer (Tokyo, Japan)
|December 3, 2002
Summary
Subareolar (SA) injection for sentinel lymph node biopsy (SNB) in breast cancer is useful but not always superior to subdermal (SD) injection. SD injection may be more effective in identifying sentinel lymph nodes in certain patient cases.
Area of Science:
- Oncology
- Surgical Oncology
- Nuclear Medicine
Background:
- Sentinel node biopsy (SNB) is crucial for breast cancer staging.
- The optimal injection site for radioisotope (RI) and blue dye in SNB remains debated.
- Subareolar (SA) injection has been proposed as an advantageous technique.
Purpose of the Study:
- To evaluate the efficacy of subareolar (SA) versus subdermal (SD) radioisotope injection for sentinel lymph node biopsy (SNB) in breast cancer patients.
- To determine if SA injection is universally applicable for all patients undergoing SNB.
Main Methods:
- Prospective study of 20 node-negative breast cancer patients (T1/T2 tumors).
- Dual radioisotope (99mTc-phytate) injection: first SA, second SD.
- Assessment of sentinel node location and number using lymphoscintigraphy (LSG) and a gamma probe.
Main Results:
- Lymphatic drainage patterns were similar for SA and SD injections in most patients.
- Two patients showed discordant sentinel node identification between SA and SD injection sites using a gamma probe.
- Subdermal (SD) injection resulted in more visualized hot nodes on LSG and higher RI counts in some patients.
- Mean RI count was higher with SA injection compared to SD injection.
Conclusions:
- While SA injection is a valuable technique, subdermal (SD) injection demonstrates greater utility in specific patient scenarios.
- Lymphatic drainage from SA and SD injection sites converges in the same nodes for the majority of patients.
- SA injection may not reliably identify sentinel lymph nodes in patients with multifocal disease or tumors in the upper outer quadrant of the breast.