title: Subareolar injection is a better technique for sentinel lymph node biopsy.
abstract: BACKGROUND
  Numerous techniques and materials show accuracy in localizing the sentinel lymph node (SLN). We hypothesized that subareolar injection of material would localize the SLN as effectively as peritumoral injection.
  
  
  METHODS
  Thirty-eight patients were injected with technetium-99 sulfur colloid either peritumorally or subareolarly in addition to the injection of blue dye around the tumor. Radioactive SLNs were localized using a hand-held gamma probe.
  
  
  RESULTS
  Nineteen patients were included in each of the two groups, peritumoral and subareolar. SLNs were found in all patients injected subareolarly and in 18 of 19 injected peritumorally. The false-negative rate was 20% for peritumoral injection and 0% for subareolar injection.
  
  
  CONCLUSIONS
  The results suggest that subareolar injection was as accurate, if not more accurate, than peritumoral injection for localizing the SLN. This technique is simpler than peritumoral injection and does not require injection under image guidance for nonpalpable lesions.
authors.affiliation: Department of Surgery, Division of Breast Surgical Oncology, University of Arkansas for Medical Sciences, John L. McClellan Memorial Veterans Hospital, Little Rock, Arkansas 72205, USA.
authors.forename: L F
authors.initials: LF
authors.lastname: Smith
authors.forename: M J
authors.initials: MJ
authors.lastname: Cross
authors.forename: V S
authors.initials: VS
authors.lastname: Klimberg
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D019275:Radiopharmaceuticals; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013671:Technetium Tc 99m Sulfur Colloid
chemical_list: D019275:Radiopharmaceuticals; D013671:Technetium Tc 99m Sulfur Colloid