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Percutaneous Biopsy and Sentinel Lymphadenectomy

Minimally Invasive Diagnosis and Treatment of Nonpalpable Breast Cancer

Laura Liberman1 and Hiram S. Cody, III2

1 Department of Radiology, Breast Imaging Section, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, NY 10021.
2 Breast Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.



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  		Fig. 1. —Asymptomatic 58-year-old woman with nonpalpable cancer proven at percutaneous imaging-guided core biopsy. Before surgery, radioisotope is injected intradermally superolateral to localizing wire.

 


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  		Fig. 2. —49-year-old woman with nonpalpable breast cancer. Frontal lymphoscintigraphic image shows intense radiotracer uptake (straight arrow) at injection site adjacent to tumor in upper outer quadrant, "blast zone." Separate focus of radiotracer uptake is present in axilla, corresponding to sentinel node (curved arrow).

 


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  		Fig. 3. —42-year-old woman with nonpalpable breast cancer. Intraoperative photograph obtained after intraparenchymal injection of blue contrast medium and axillary incision shows blue sentinel node (arrow). Two blue afferent lymphatics (arrowheads) are also identified.

 

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