Abstract
Background. The technique of sentinel lymph node (SLN) biopsy in patients with breast cancer
varies among reports, and the optimal method remains to be established, particularly
with regard to the site of radiotracer injection. The aim of this study was to compare
periareolar and peritumoral injection of radiotracer in detecting SLN in patients
with breast cancer. Methods. Patients with T1-2 breast cancer (n = 155) were enrolled in this study. In phase
1 (n = 62), SLN biopsy was performed by using peritumoral injection of blue dye alone
followed by backup axillary lymph node dissection. In phase 2, SLN biopsy was performed
by using peritumoral injection of blue dye and peritumoral (group A, n = 41) or periareolar
(group B, n = 52) injection of technetium 99m tin colloid. Results. In phase 1, the detection rate of SLN was 81% and the false-negative rate was 5.6%,
indicating our skill in SLN biopsy. In phase 2, the success rate of lymphoscintigraphy
was significantly (P <.001) higher in group B (90%) than in group A (51%). The mean ex vivo radioactivity
of SLN in group B (117 counts per second; range, 5 to 900) was also significantly
(P <.05) higher than in group A (51 counts per second; range, 8 to 260). In addition,
the detection rate of SLN was significantly (P <.05) higher in group B (100%) than in group A (90%). Conclusions. Periareolar injection of radiotracer for SLN biopsy is superior to peritumoral injection
because of its simplicity, achieving a high success rate in lymphoscintigraphy and
SLN detection. (Surgery 2002;131:277-86.)
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Article info
Publication history
Accepted:
October 28,
2001
Footnotes
*Supported in part by a Grant-in-aid for Science Research from the Ministry of Education, Sports, Science, and Technology of Japan.
**Reprint requests: Shinzaburo Noguchi, MD, Department of Surgical Oncology, Osaka University Medical School, 2-2-E10 Yamada-oka, Suita, Osaka 565-0871, Japan.
Identification
Copyright
© 2002 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
