Intradermal Isotope Injection: A Highly Accurate Method of Lymphatic Mapping in Breast Carcinoma

Abstract

These data demonstrate that intradermal injection of radioactive tracer is an effective method of localizing the SLN in cases involving small breast cancers. Further investigation is warranted before this technique is adopted for use in larger breast cancers. Intraoperative examination and biopsy of any suspicious nonsentinel nodes are critical.

Localization of the Sentinel Node in Breast Cancer: Identical Results With Same-Day and Day-Before Isotope Injection

“…Our own technique evolved over our first 1000 procedures. 10 In a logical sequence of studies, we have previously demonstrated (1) the complementarity of isotope and blue dye, 8 -11 (2) the superiority of unfiltered over 220 nm filtered 99m Tc-labeled sulfur colloid, 12 (3) the advantage of intradermal over intraparenchymal isotope injection, 13,14 and (4) an overall success in identifying the SLN, which continued to increase over our first 500 procedures. 15 We also demonstrated (5) that false negative results were most common in the early experience of each surgeon.…”

The sentinel node biopsy after previous breast surgery: preliminary results on 543 patients treated at the European Institute of Oncology

“…As a consequence, one of the current fields of investigation is determining the best injection site for sentinel node identification [6,7]. Some data seem to suggest that a retro-areolar injection could be adequate for the majority of tumor localization in the breast [8,9].…”

Diagnostic performance of fluorodeoxyglucose-positron emission tomography/computed tomography of breast cancer in detecting axillary lymph node metastasis: comparison with ultrasonography and contrast-enhanced CT

“…Sentinel lymph node biopsy may result in a false negative in 1-15% of patients [7][8][9]. Most of these false-negatives are due to massive lymph node metastasis in the first drainage node, which divert lymphatic drainage away from the node [25]. When an attempt to apply sentinel lymph node biopsy for larger tumors is made, PET/CT might serve to identify patients at risk of a false-negative sentinel lymph node biopsy [19].…”