Abstract PS1-32: A multicentre prospective feasibility study of carbon dye tattooing of biopsied axillary node and surgical localisation in breast cancer patients

Abstract

Abstract Background: The primary aim of this prospective, multicentre feasibility study was to determine whether the biopsied axillary node in patients with breast cancer can be marked using black carbon dye and successfully identified at the time of surgery. Methods: We included patients undergoing needle biopsy of the axillary lymph gland. The biopsied node was tattooed at the time of needle biopsy (fine needle aspiration or core biopsy) or at a separate visit with black carbon dye (Spot™ or Black Eye™). Participants underwent primary surgery or neoadjuvant chemotherapy and axillary surgery (SNB or ALND) as per routine care. Results: 110 patients were included. Median age of the women was 59 (range 31 to 88) years. 48 of 110 (44%) underwent SNB and 62 (56%) ALND. The median volume of dye injected was 2.0 ml (range 0.2-4.2).Tattooed node was identified in 90 of 110 (82%) patients. The identification rate was higher (86%) in the primary surgery group compared with NACT (64%). Of those undergoing NACT, the identification rate was better in the patients undergoing SNB (3 of 4, 75%) compared with ALND (11 of 18, 61%). The tattooed node was the sentinel node in 78% (28 of 36) patients in the primary surgery group and 100% (3 of 3) in the NACT group. For surgeons who had performed ≥5 operations, there was no learning curve. The identification rate did not vary with body mass index or volume of dye injected. There was no correlation between volume of dye and number of tattooed nodes removed. Conclusion: It is feasible to mark the axillary node with carbon dye and identify it intraoperatively. Modifications of the technique, such as injecting the dye in the cortex alone, restricting the volume to 0.2 to 0.4 ml and combining with clip, will improve the technical ability to identify the marked node. Citation Format: Amit Goyal, Shama Puri, Andrea Marshall, Kalliope Valassiadou, Moin Hoosein, Amtul R Carmichael, Gabriella Erdelyi, Nisha Sharma, Janet Dunn, Joanne York. A multicentre prospective feasibility study of carbon dye tattooing of biopsied axillary node and surgical localisation in breast cancer patients [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS1-32.