Validation study of the modified injection technique for internal mammary sentinel lymph node biopsy in breast cancer

Abstract

Objective To verify the accuracy of the modified technique for internal mammary sentinel lymph node biopsy(IM-SLNB)in breast cancer. Methods In the validation study, the radiotracer was injected with the modified technique, and fluorescence tracer was injected into the peritumoral breast tissue. The radioactive IM-SLN was identified by preoperative lymphoscintigraphy and γ probe. The radioactive IM-SLN received biopsy during operation. The status of the fluorescence tracer was identified by the fluorescence imaging system. Results A total of 162 patients were enrolled from Sep. 2013 to Dec. 2014. IM-SLNB was performed in 110 patients. The radiotracer and the fluorescence tracer were identified in the same IM-SLN in 94 cases, and the concordance rate was 85.5%(Case-base, Spearman coefficient correlation 0.823, P<0.001). Conclusion Different tracers injected into the different sites of the intra-parenchyma can reach the same IM-SLN, proving the accuracy of the modified technique and the hypothesis of IM-SLN lymphatic drainage pattern(IM-SLN receives not only the lymphatic drainage from the primary tumor area but the entire breast parenchyma). Key words: Breast Cancer; Internal Mammary; Sentinel Lymph Node Biopsy; Visualization rate