What is the radiocolloid peritumoral injection technique for breast cancer lymphoscintigraphy (sentinel lymph node mapping)?

Updated: Dec 13, 2018
  • Author: Durre Sabih, MBBS, MSc, FRCP(Edin); Chief Editor: Mahan Mathur, MD  more...
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Answer

Answer

In the peritumoral injection technique, the injection is made deeper into the breast parenchyma around the mass. (See the image below.)

Intraparenchmal injections. Note the needle inject Intraparenchmal injections. Note the needle injects within the parenchyma around the lesion.

Usually, 4 injections are made around the tumor. The volume of injectate is larger, with 1-2 mL injected at each injection site to make a total volume of 4-8 mL. The injections are made superior, inferior, lateral, and medial to the mass. Another technique is to inject in a semicircle along the axillary side of the mass.

If the mass is nonpalpable, ultrasound guidance can be used for needle placement.

The patient is asked to massage over the injection site and between the injection site and axilla for at least 1-2 minutes. (See the image below.)

Postinjection massage. Dry cotton is used to massa Postinjection massage. Dry cotton is used to massage the injection site to encourage lymph flow with the radiocolloid towards the sentinel node.

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