title: Reproducibility of lymphoscintigraphy before and after excisional biopsy of primary breast lesions: a study using superficial peri-areolar injection of the radiotracer.
abstract: OBJECTIVE
  A major controversial issue in the sentinel node biopsy of the breast is the applicability of sentinel node mapping in patients with the history of previous excisional biopsy of the breast lesions. In the current study, we evaluated the reproducibility of lymphoscintigraphy before and after excisional biopsy of the primary breast lesions using superficial peri-areolar injection of the radiotracer.
  
  
  METHODS
  Eighteen patients scheduled for excisional biopsy of breast lesions were included into the study. The patients received intra-dermal injection of the radiotracer in the peri-areolar area of the index quadrant 1 to 2h before surgery. Imaging was performed the day after surgery. Immediately after completion of the first imaging, the patients received another injection of the radiotracer with the same technique, dose, and location. Other sets of lymphoscintigraphy imaging were taken immediately and 4h post second injection. The two sets of lymphoscintigraphy images were compared.
  
  
  RESULTS
  In 2 patients, sentinel node could not be identified in either set of images. In the remaining 16 patients, one sentinel node was detected in both lymphoscintigraphy image sets. The sentinel nodes of the second image sets were all in the same location of the first sets with at least 5 times higher count.
  
  
  CONCLUSIONS
  Excisional biopsy of the primary breast lesions does not seem to change the superficial lymphatic drainage pattern from the areola of the breast and sentinel node mapping can be performed after this procedure using superficial periareolar technique.
authors.affiliation: Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: M
authors.initials: M
authors.lastname: Asadi
authors.forename: H
authors.initials: H
authors.lastname: Shobeiri
authors.forename: M
authors.initials: M
authors.lastname: Aliakbarian
authors.forename: A
authors.initials: A
authors.lastname: Jangjoo
authors.forename: V R
authors.initials: VR
authors.lastname: Dabbagh Kakhki
authors.forename: R
authors.initials: R
authors.lastname: Sadeghi
authors.forename: M
authors.initials: M
authors.lastname: Keshtgar
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000965:Antimony / Q000008:administration & dosage; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007267:Injections / Q000379:methods; D061305:Lymphoscintigraphy; D008875:Middle Aged; D009558:Nipples; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy; D017556:Technetium Compounds / Q000008:administration & dosage
chemical_list: D017556:Technetium Compounds; C019096:technetium Tc 99m antimony sulfide; D000965:Antimony