Peritumoral Injection in Sentinel Lymph Node Breast Biopsy
Injection of isosulphan blue dye and technetium in the area around the tumor as has been classically described in sentinel lymph node biopsy has limitations in patients with upper outer quadrant breast lesions.
One group of researchers (Krag, et al.) described using technetium Tc 99m sulfur colloid. They reported that when this was injected in the area around the tumor it resulted in 100% of the false negatives in the study.
It was theorized by this group that because the lymphatics converge in the axilla, widely spaced injects around the tumor could miss the one important sentinel channel. It is also possible that false negatives arise because the site of injection is sufficiently close to the axilla that high background activity may make it difficult to localize the sentinel node with the gamma probe.
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