| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
ORIGINAL ARTICLES |
From the Departments of Surgery (TWB, FRS, LSC, IB, DLF, BJC), Nuclear Medicine (AA), Radiology (SPW), and Biostatistics and Epidemiology (RM), School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and the Department of Surgery (TLB), York Hospital, York, Pennsylvania.
Correspondence: Address correspondence and reprint requests to: Brian J. Czerniecki, MD, PhD, Department of Surgery, 4 Silverstein, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104; Fax: 215-662-7476; E-mail: czerniec{at}mail.med.upenn.edu
Background: Sentinel lymph node (SLN) mapping with radioisotope and blue dye is rapidly becoming the standard of care for breast cancer. The optimal location for injection of radioisotope and blue dye is still being investigated. The goal of this study was to determine whether blue dye injection into the subareolar (SA) location localized the same sentinel nodes as the peritumoral (PT) location for patients with breast cancer.
Methods: Three hundred thirty-two patients with biopsy-proven operable breast cancer or ductal carcinoma in situ at two institutions underwent SLN mapping. Eighty-three patients had PT injection of blue dye (group 1), and 249 patients had SA injection of blue dye (group 2). All patients underwent PT injection of 99mTc-labeled sulfur colloid.
Results: The two groups were similar in age, previous biopsy type, and tumor size, location, and histology. The mean number of SLNs identified was 2.4 (range, 0–9) in group 1 and 2.5 (range, 0–11) in group 2. The SLN identification rate was 95% for group 1 and 97% for group 2. The isotope success rate was 94% for both groups. The blue dye success rate was 84% for group 1 and 90% for group 2. The isotope/blue dye concordance rate was 87% for group 1 and 90% for group 2. At a median follow-up of 28 months (range, 14 to 40), there were no axillary recurrences in any of the 332 patients.
Conclusions: These data suggest that delivery of mapping reagents in the SA and PT locations identifies similar lymph nodes. Because of simplicity and the similarity in node identification between SA and PT injection, further investigation of the SA site for delivery of SLN mapping reagents for breast cancer is warranted.
Key Words: Sentinel lymph node mapping • Subareolar injection • Blue dye • Radioisotope • Breast cancer
This article has been cited by other articles:
 |
|
 |
|
  J.-F. Rodier, M. Velten, M. Wilt, P. Martel, G. Ferron, V. Vaini-Elies, H. Mignotte, A. Bremond, J.-M. Classe, F. Dravet, et al. Prospective Multicentric Randomized Study Comparing Periareolar and Peritumoral Injection of Radiotracer and Blue Dye for the Detection of Sentinel Lymph Node in Breast Sparing Procedures: FRANSENODE Trial J. Clin. Oncol., August 20, 2007; 25(24): 3664 - 3669. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. P. Povoski, J. O. Olsen, D. C. Young, J. Clarke, W. E. Burak, M. J. Walker, W. E. Carson, L. D. Yee, D. M. Agnese, R. V. Pozderac, et al. Prospective Randomized Clinical Trial Comparing Intradermal, Intraparenchymal, and Subareolar Injection Routes for Sentinel Lymph Node Mapping and Biopsy in Breast Cancer Ann. Surg. Oncol., November 1, 2006; 13(11): 1412 - 1421. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Knauer, P. Konstantiniuk, A. Haid, E. Wenzl, M. Riegler-Keil, S. Postlberger, R. Reitsamer, and P. Schrenk Multicentric Breast Cancer: A New Indication for Sentinel Node Biopsy--A Multi-Institutional Validation Study J. Clin. Oncol., July 20, 2006; 24(21): 3374 - 3380. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. D'Eredita, C. Giardina, A. M. Guerrieri, and T. Berardi A Further Validation of Subareolar Injection Technique for Breast Sentinel Lymph Node Biopsy Ann. Surg. Oncol., May 1, 2006; 13(5): 701 - 707. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Wada, S. Imoto, C. Yamauchi, T. Hasebe, A. Ochiai, and S. Ebihara Correlation Between Concordance of Tracers, Order of Harvest, and Presence of Metastases in Sentinel Lymph Nodes With Breast Cancer Ann. Surg. Oncol., June 1, 2005; 12(6): 497 - 503. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. M. Kuerer and L. A. Newman Lymphatic Mapping and Sentinel Lymph Node Biopsy for Breast Cancer: Developments and Resolving Controversies J. Clin. Oncol., March 10, 2005; 23(8): 1698 - 1705. [Full Text] [PDF]
|
|
|
|
|
|
T. G. Zogakis, R. E. Wetherille, R. D. Christensen, K. J. Ose, J. D. Friedman, M. Colbert, C. A. Svendsen, O. K. Sanan, and T. M. Tuttle Intraoperative Subareolar Injection of 99mTc-Labeled Sulfur Colloid Results in Consistent Sentinel Lymph Node Identification Ann. Surg. Oncol., February 1, 2005; 12(2): 167 - 172. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Chagpar, R. C. Martin III, C. Chao, S. L. Wong, M. J. Edwards, T. Tuttle, and K. M. McMasters Validation of Subareolar and Periareolar Injection Techniques for Breast Sentinel Lymph Node Biopsy Arch Surg, June 1, 2004; 139(6): 614 - 620. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Pelosi, M. Bello, M. Giors, A. Ala, R. Giani, R. Bussone, and G. Bisi Sentinel Lymph Node Detection in Patients with Early-Stage Breast Cancer: Comparison of Periareolar and Subdermal/Peritumoral Injection Techniques J. Nucl. Med., February 1, 2004; 45(2): 220 - 225. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. D'Eredita', F. Ferrarese, V. Cecere, S. T. Massa, F. de Carne, and G. Fabiano Subareolar Injection May Be More Accurate Than Other Techniques for Sentinel Lymph Node Biopsy in Breast Cancer Ann. Surg. Oncol., October 1, 2003; 10(8): 942 - 947. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
