title: The impact of previous para-areolar incision in the upper outer quadrant of the breast on the localization of the sentinel lymph node in a canine model.
abstract: OBJECTIVE
  This paper discusses the influence of a para-areolar incision in the upper outer quadrant of the breast on the location of the sentinel lymph node in a canine model.
  
  
  METHODS
  The sentinel lymph node was marked with technetium-99, which was injected into the subareolar skin of the cranial breast. After the marker had migrated to the axilla, an arcuate para-areolar incision was performed 2 cm from the nipple in the upper outer quadrant. Patent blue dye was then injected above the upper border of the incision. At the marked site, an axillary incision was made, and the sentinel lymph node was identified by gamma probe and/or by direct visualization of the dye. The agreement between the two injection sites and the two sentinel lymph node identification methods was determined. Our sample group consisted of 40 cranial breasts of 23 adult females of the species Canis familiaris. The data were analyzed by using the McNemar test and by determining the kappa agreement coefficient.
  
  
  RESULTS
  Our findings showed that in 95% of the breasts, the sentinel lymph node was identified by the injection of technetium-99 m into the subareolar region, and in 82% of the cases, the sentinel lymph node was identified by the injection of patent blue dye above the upper border of the incision. The methods agreed 82% of the time.
  
  
  CONCLUSIONS
  Previous para-areolar incisions in the upper outer quadrant did not interfere significantly with the biopsy when the dye was injected above the upper border of the incision.
authors.affiliation: Department of Surgery, Federal University of Ceará , Fortaleza, Ceará, Brazil.
authors.forename: Paulo Henrique Diógenes
authors.initials: PH
authors.lastname: Vasques
authors.forename: Luiz Gonzaga Porto
authors.initials: LG
authors.lastname: Pinheiro
authors.forename: João Marcos de Meneses E
authors.initials: JM
authors.lastname: Silva
authors.forename: José Ricardo de Moura
authors.initials: JR
authors.lastname: Torres-de-Melo
authors.forename: Karine Bessa Porto
authors.initials: KB
authors.lastname: Pinheiro
authors.forename: João Ivo Xavier
authors.initials: JI
authors.lastname: Rocha
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D004285:Dogs; D005260:Female; D015674:Mammary Neoplasms, Animal / Q000000981:diagnostic imaging* / Q000473:pathology*; D009558:Nipples / Q000601:surgery; D011877:Radionuclide Imaging; 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