The impact of previous para-areolar incision in the upper outer quadrant of the breast on the localization of the sentinel lymph node in a canine model

Abstract

OBJECTIVES:This paper discusses the influence of a para-areolar incision in the upper outer quadrant of the breast on the location of the sentinel lymph node in a canine model.METHODS:The sentinel lymph node was marked with technetium-99, which was injected into the subareolar skin of the cranial breast. After the marker had migrated to the axilla, an arcuate para-areolar incision was performed 2 cm from the nipple in the upper outer quadrant. Patent blue dye was then injected above the upper border of the incision. At the marked site, an axillary incision was made, and the sentinel lymph node was identified by gamma probe and/or by direct visualization of the dye. The agreement between the two injection sites and the two sentinel lymph node identification methods was determined. Our sample group consisted of 40 cranial breasts of 23 adult females of the species Canis familiaris. The data were analyzed by using the McNemar test and by determining the kappa agreement coefficient.RESULT:Our findings showed that in 95% of the breasts, the sentinel lymph node was identified by the injection of technetium-99 m into the subareolar region, and in 82% of the cases, the sentinel lymph node was identified by the injection of patent blue dye above the upper border of the incision. The methods agreed 82% of the time.CONCLUSIONS:Previous para-areolar incisions in the upper outer quadrant did not interfere significantly with the biopsy when the dye was injected above the upper border of the incision.

Use of indirect lymphography to identify sentinel lymph node in dogs: a pilot study in 30 tumours

“…The authors suggested that scar tissue would affect proper detection of the SLN. This limitation to SLN mapping has also been reported in some human patients …”

Preoperative planar lymphoscintigraphy allows for sentinel lymph node detection in 51 dogs improving staging accuracy: Feasibility and pitfalls

“…Few studies have reported decreased SLN identification rate in patients where the lymphatic network was disrupted by a previous surgery 28,29 or radiotherapy 30 . Hlusko et al 31 investigated the impact of surgery on the drainage patterns from the canine brachium, demonstrating a partial agreement between preoperative and postoperative lymphoscintigraphy, and Vasques et al 32 showed that para‐areolar incision in the upper outer quadrant of the first mammary gland did not significantly interfere with SLN identification in a canine model. However, both studies were conducted on healthy dogs, and data on tumor‐bearing dogs is still lacking.…”