A tattoo pigmented node and breast cancer

Area of Science:

• Oncology
• Surgical Pathology
• Medical Imaging

Background:

• Axillary sentinel lymph node biopsy (SLNB) is standard for early breast cancer staging.
• Routine axillary lymph node dissection (ALND) is largely replaced by SLNB.
• Tattoo dye migration into lymph nodes presents a diagnostic challenge.

Observation:

• A case report details a breast cancer patient with a tattoo.
• Tattoo pigment can cause superficial axillary lymph nodes to appear pigmented.
• These pigmented nodes may be mistaken for true sentinel lymph nodes.

Findings:

• Pigmented "pseudo-sentinel" nodes can mimic true sentinel nodes visually.
• Superficial location of these nodes increases the risk of misidentification.
• Failure to identify the true sentinel node can lead to understaging.

Implications:

• Accurate sentinel lymph node identification is critical for correct breast cancer staging.
• Awareness of tattoo pigment's effect on lymph nodes is essential for surgeons.
• This highlights the need for meticulous surgical technique in SLNB procedures.