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Dermal invasion matters in breast cancer sentinel lymph node biopsy results

  • Montserrat Solà1,*,
  • Mireia Recaj2
  • Eva Castellà3
  • Antonio Urban4
  • Laura Hernández3
  • Juan Francisco Julian5
  • Gloria Moragas1

1Department of Nuclear Medicine, Hospital Universitari Germans Trias i Pujol de Badalona, 08916 Badalona, Spain

2Department of Surgery, General Hospital Sant Jaume de Calella, 08370 Calella, Spain

3Department of Pathology, Hospital Universitari Germans Trias i Pujol de Badalona, 08916 Badalona, Spain

4Department of Pathology, Hospital Sant Jaume de Calella, 08370 Calella, Spain

5Department of Surgery, Hospital Universitari Germans Trias i Pujol de Badalona, 08916 Badalona, Spain

DOI: 10.22514/ejgo.2022.029 Vol.43,Issue 4,August 2022 pp.101-105

Submitted: 03 June 2022 Accepted: 13 July 2022

Published: 15 August 2022

*Corresponding Author(s): Montserrat Solà E-mail:


The aim of this study was to evaluate whether cancer invasion of the dermis could hamper drainage of the radiotracer in breast cancer patients who were undergoing a Sentinel Lymph Node Biopsy (SLNB) procedure. Ten patients who presented with T1-T2 breast cancer with dermal invasion alone as confirmed by a punch biopsy of skin were evaluated. For the SLNB procedure, a lymphoscintigraphy was performed 2 hours after intratumoral administration of 2 mCi (74 MBq) of 99mTc nanocolloid. The sentinel lymph nodes (SLN) were evaluated for the presence of tumor cells by hematoxylin-eosin staining and, when negative, by immunocytochemistry using anti-cytokeratin antibody (CAM 5.2). No migration of radiotracer was found in three patients, and one patient had a false negative SLN, so altogether the technique failed in four patients (40%). Axillary nodes proved to be positive in seven patients (70%).The high rate of failure in the lymphatic mapping and the high proportion of axillary positivity suggest a causal relationship with the invasion of the dermis, with possible implications for the validity of the SLNB procedure.


Sentinel node; Breast; Dermal invasion

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Montserrat Solà,Mireia Recaj,Eva Castellà,Antonio Urban,Laura Hernández,Juan Francisco Julian,Gloria Moragas. Dermal invasion matters in breast cancer sentinel lymph node biopsy results. European Journal of Gynaecological Oncology. 2022. 43(4);101-105.


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[3] Lyman GH, Somerfield MR, Bosserman LD, Perkins CL, Weaver DL, Giuliano AE. Sentinel lymph node biopsy for patients with early-stage breast cancer: American society of clinical oncology clinical practice guideline update. Journal of Clinical Oncology. 2017; 35: 561–564.

[4] Fraile M, Rull M, Julian FJ, Fuste F, Barnadas A, Llatjos M, et al. Sentinel node biopsy as a practical alternative to axillary lymph node dissection in breast cancer patients: an approach to its validity. Annals of Oncology. 2000; 11: 701–705.

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