Pre-Operative Localization of Axillary Lymph Nodes with Tattoo Ink: A Preliminary Report

Kelly S Myers; Sachin Aggarwal; Eniola T Oluyemi; Mehran Habibi; Emily B Ambinder; Armina Azizi; Parvinder Sujlana; Jessica Hung; Nagi Khouri; David Eisner; Philip A Di Carlo; Ashley M Cimino-Mathews; Melissa S Camp

doi:10.32768/abc.202182143-148

Archives of Breast Cancer (Apr 2021)

Pre-Operative Localization of Axillary Lymph Nodes with Tattoo Ink: A Preliminary Report

Kelly S Myers,
Sachin Aggarwal,
Eniola T Oluyemi,
Mehran Habibi,
Emily B Ambinder,
Armina Azizi,
Parvinder Sujlana,
Jessica Hung,
Nagi Khouri,
David Eisner,
Philip A Di Carlo,
Ashley M Cimino-Mathews,
Melissa S Camp

Affiliations

Kelly S Myers: Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
Sachin Aggarwal: Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
Eniola T Oluyemi: Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
Mehran Habibi: Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
Emily B Ambinder: Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
Armina Azizi: Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
Parvinder Sujlana: Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
Jessica Hung: Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
Nagi Khouri: Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
David Eisner: Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
Philip A Di Carlo: Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
Ashley M Cimino-Mathews: Department of Pathology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
Melissa S Camp: Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA

DOI: https://doi.org/10.32768/abc.202182143-148

Abstract

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Background: Pre-operative localization options in the axilla are limited. This study aimed to explore the utility of pre-operative localization of axillary lymph nodes using tattoo ink with multidisciplinary correlations. Methods: In this prospective, Institutional Review Board (IRB)-approved study, 19 lymph nodes in 17 patients underwent pre-operative localization with ultrasound-guided injection of Spot tattoo ink. The success rate of intraoperative identification of the tattooed node as well as the frequency in which the tattooed node was also a sentinel node were recorded. Radiologic, surgical and pathologic images were collected. Results: Tattoo ink localization was successful in 16/17 (94.1%) of patients. Tattoo ink did not hinder pathologic evaluation in any cases but was taken up by additional adjacent nodes in 1/17 successful localizations (5.9%). Successful sentinel lymph node biopsy (SLNB) occurred in 13 patients in whom 14 lymph nodes underwent pre-operative tattoo ink localization. Nine of the 14 (64.2%) tattooed lymph nodes were also a sentinel node. Conclusion: In this study, pre-operative localization of axillary lymph nodes with tattoo ink was highly successful In patients undergoing SLNB, a significant number of the tattooed nodes were not sentinel nodes (35.8%), suggesting the importance of targeted lymph node excision in addition to SLNB.

Published in Archives of Breast Cancer

ISSN: 2383-0433 (Online)
Publisher: Kaviani Breast Disease Institute
Country of publisher: Iran, Islamic Republic of
LCC subjects: Medicine: Internal medicine: Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Website: http://archbreastcancer.com

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