FACULTY COMMENTS

DR DIXON: The science behind injection site location for lymphatic mapping is not clear. Studies suggest that if you inject technetium in the subareolar region and blue dye around the tumor, the injections drain to the same sentinel nodes. I’m not convinced utilizing two injection sites provides benefit. Furthermore, I find injecting peritumorally to be messy when performing surgery, especially when I want to see what’s going on, to see the bleeding. When I first started, I injected peritumorally but have since converted to subareolar.

Subareolar injection is easy, straightforward and more commonly practiced, which is especially important when considering the issue of so many impalpable tumors. The radiologist injects the radioisotope around the tumor, and evidence shows this works quite well.

Conversely, other studies have found that “The deep aspects of the breast and the parenchyma drain differently to the subareolar region.” However, we’ve done a fairly large study on subareolar injection and have shown highly effective sentinel node mapping with a low false-negative rate.

 

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Editor's Note
State of the art 2008
Neil Love, MD

Slides and Faculty Comments

Sentinel Lymph Node Biospy (LSNB) Relative to Neoadjuvant Systemic Therapy

Neoadjuvant Systemic Therapy

Sentinel Node Biopsy Injection Site

Partial Breast Irradiation (PBI)

Genomic Assays: Prediction of Benefit from Chemotherapy

Hormone Receptor-Positive Breast Cancer

Assessment of Her2 Status

- Select Publications

A CME Audio Series and Activity

Faculty Disclosures

Editor's Office