Long-term follow-up results of breast cancer patients with sentinel lymph node biopsy using periareolar injection
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Updated: Jun 21, 2026

The Application of 1% Methylene Blue Dye As a Single Technique in Breast Cancer Sentinel Node Biopsy
Published on: June 1, 2019
Mitsunobu Imasato1, Kenzo Shimazu, Yasuhiro Tamaki
1Department of Breast and Endocrine Surgery, Graduate School of Medicine, Osaka University, 2-2-E10 Yamada-oka Suita, Osaka 565-0871, Japan.
Background:
Areolar injection for sentinel lymph node biopsy (SLNB) in breast cancer surgery has been adopted by many institutions. However, only one study has reported the follow-up results for patients whose SLNB was performed with this injection method alone.
Methods:
Three hundred eighty patients with breast cancer underwent SLNB with periareolar injection of both blue dye and radiotracer. The follow-up consisted of a physical examination every 3 months and annual mammography.
Results:
Of 380 patients with SLNB, 261 were found to have negative sentinel lymph nodes so that no ALND was performed. At a median follow-up of 39 months (range 13-74), 2 of the 261 patients developed axillary recurrence for an axillary relapse incidence of .77%. Five-year distant disease-free survival was 96.9%, and overall survival was 99.4%.
Conclusions:
The incidence of axillary recurrence for the areolar injection method was low and consistent with that reported in other observational studies using other injection methods.
