Lymphatic mapping in breast cancer: combination technique.

Abstract

The current standard of care for patients with invasive breast cancer is complete removal of the tumor by mastectomy or lumpectomy, with documentation of negative margins, followed by complete axillary dissection. Our group has examined the efficacy of lymphatic mapping of the sentinel node via the combination technique in 594 patients with breast cancer. A radiocolloid was injected at six intraparenchymal locations surrounding the tumor 2 hours prior to the operation. A 1% solution of isosulfan blue dye was injected into the breast just before prepping the patient. The breast was compressed and massaged for 5 minutes. The surgical and pathological data were prospectively collected. Lymphatic mapping of the sentinel node with a combination of blue dye and radiocolloid enhanced preop localization, operation efficiency, internal mammary node detection, and quantitative measure of detection. The combined technique also significantly reduced the learning curve for achieving proficiency.