Rationale for superficial injection techniques in lymphatic mapping in breast cancer patients

Abstract

One of the most avidly debated issues in lymphatic mapping is where the tracers are best deposited in patients with breast cancer. The four superficial approaches are easy to perform and have several other distinct advantages. They are based on the hypothesis that the entire breast parenchyma and the overlying skin drain to a common node in the axilla because of their common embryological origin. Evidence is presented that casts doubt upon the correctness of this assumption. Tracer administration close to the tumor site appears to be the safest approach for the time being. Excellent results can be obtained with this latter approach, despite the fact that it is technically more demanding.

Sentinel lymph node biopsy in early breast cancer surgery – Working with the risks of vital blue dye to reap the benefits

“…The exact site of injection of the mapping agent varies between studies [19][20][21][22][23][24][25] , but can be broadly divided into "superficial" or "deep" 19 . Radioactive colloid is injected preoperatively, with the assistance of radiological imaging either around the tumour, or into the overlying skin.…”

The management of contralateral axillary sentinel lymph nodes detected by lymphoscintigraphy in a patient of breast cancer that had never undergone breast related medical treatment

“…The majority of extra-axillary sites were internal mammary lymph nodes, and a few were intramammary or supraclavicular lymph nodes [4][5][6]. Previous studies have reported that the frequency of SN detection depended on the radiocolloid particle size and injection site [13][14][15][16][17][18][19]. The analysis in our institution showed that SN biopsy procedures performed with the intradermal-plus-deep injection method were found to be significantly superior to those involving intradermal injection alone in terms of their ability to detect axillary SN (No.…”

Sentinel Lymph Node Biopsy: Actual Approaches

“…Tüm bu teknikler aksiller lenf bezi saptamada yeterli olarak bulunmuştur. Yapılan çalışmalarda enjeksiyon metodunun aksiller SLB saptamada fark yaratmadığı bulunmuştur (25). Yüzeyel enjeksiyonların yapılması daha kolaydır.…”