Lanchas Alfonso I, Miguel Martínez M B, CuezvaGuzmán J F, Rupérez Arribas P, Martínez Blanco S, Yartu San Millán J M, Duque Gallo J J
Servicio de Medicina Nuclear, Complejo Asistencial de Burgos, Burgos, Spain.
Rev Esp Med Nucl. 2011 May-Jun;30(3):171-3. doi: 10.1016/j.remn.2010.07.006. Epub 2011 Feb 20.
The use of deep (intratumoral, peritumoral) and superficial (subdermal, subareolar) administration is recognized as valid in sentinel lymph node biopsy for breast cancer. Herein, we are presenting a clinical case in which a personalized methodology was a determining factor in axillary staging. Initially, the radiotracer was injected intratumorally guided by ultrasound. The ultrasound scan identified a previously unknown axillary lymphadenopathy, with focal cortical thickening, this being a non-specific ultrasound finding, but with possibility of biopsy. The lymphoscintigraphy did not show uptake in the mentioned node, hence, a second subareolar dose was administered. On this occasion, the lymphoscintigraphy detected drainage to the sentinel node, which was the only one positive for micrometastases.