title: Subareolar sentinel node biopsy for multiple breast cancers.
abstract: BACKGROUND
  Sentinel lymph node biopsy (SLNB) is deemed suitable only for unifocal breast cancers since multiple foci of cancers may drain to different nodes. We hypothesized that subareolar injection (SI) could identify the sentinel lymph nodes (SLN) accurately in patients with multiple cancers (MC) in the breast.
  
  
  METHODS
  We prospectively employed SI of lymphazurin or technetium sulfur colloid, or both, for the identification of SLN in patients with MC in the breast. All patients underwent axillary dissection to compute the accuracy of SLNB.
  
  
  RESULTS
  Forty patients presented with MC in the same breast between January 1996 and July 2002. Fifty-two percent (21 of 40) of patients had involvement of more than 1 quadrant; 18% (7 of 40) had more than 1 histologic type of cancers. SLNs were successfully identified in 100% of patients. Axillary disease was present in 63% (25 of 40) of patients. Sensitivity of SLNB was 100% and false negative rate was 0%. The SLN was the only node involved in 45% (18 of 40) of patients.
  
  
  CONCLUSIONS
  SLNB using the SI technique may be an alternative to complete axillary dissection in patients with multiple breast cancers.
authors.affiliation: Department of Surgery, Arkansas Cancer Research Center, Central Arkansas Veterans Healthcare System, Little Rock, AR, USA.
authors.forename: Rakhshanda
authors.initials: R
authors.lastname: Layeeque
authors.forename: Ronda
authors.initials: R
authors.lastname: Henry-Tillman
authors.forename: Soheila
authors.initials: S
authors.lastname: Korourian
authors.forename: Rena
authors.initials: R
authors.lastname: Kass
authors.forename: V Suzanne
authors.initials: VS
authors.lastname: Klimberg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D007267:Injections; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000473:pathology*; D009558:Nipples; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*