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Complement of peritumoral and subareolar injection in breast cancer sentinel lymph node biopsy
Journal of Surgical Oncology, 06/04/09

Noguchi M et al. - In a trial to assess whether a combination of peritumoral (PT) injection and subareolar (SA) injection can improve identification rate of sentinel lymph node (SLN) biopsy and decrease the false-negative rate, it was concluded that the success of SLN mapping is optimized not only by using dye and isotope in combination but also by using PT and SA injections in combination.

Methods

201 pts underwent SLN biopsy with PT injection of radioisotope and SA injection of blue dye.

Results

Overall identification rate for blue and/or hot lymph nodes was 99.5%; identification rate of blue-dyed lymph nodes was 98.0% and that of hot lymph nodes was 97.0%.
No concordance between the hot node and the blue node was found in 17 pts (8.5%).
Among 51 SLN-positive pts, 4 had blue-only positive SLN and 7 had hot-only positive SLN.
False-negative rates were at least 7.8% for PT injection and 13.7% for SA injection, while axillary lymph node dissection was not performed in SLN-negative pts.
A combination of both injections significantly decreased the false-negative rate.

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