Inyección intratumoral versus subareolar en el diagnóstico de la biopsia del ganglio centinela, en el carcinoma de mama. A propósito de un caso / Intratumoral versus subareolar injection in breast cancer sentinel lymph node biopsy. A case report

La utilización de las vías de administración profunda (intratumoral, peritumoral) y superficial (subdérmica, subareolar) están reconocidas como válidas en la biopsia del ganglio centinela en el cáncer de mama. Presentamos un caso clínico en donde la individualización de la metodología fue determinante en la estadificación axilar. Inicialmente se administra el radiotrazador por vía intratumoral guiada por ecografía. En dicha exploración se identifica una adenopatía axilar no conocida previamente, con engrosamiento cortical focal, hallazgo ecográfico inespecífico, pero subsidiario de biopsia. La linfogammagrafía no mostró captación en dicho ganglio, por lo que se decide reinyección de una 2.ª dosis por vía subareolar. En esta ocasión la linfogammagrafía detecta drenaje a dicho ganglio centinela, siendo el único de los analizados que resultó positivo para micrometástasis(AU)

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(AU)

[Intratumoral versus subareolar injection in breast cancer sentinel lymph node biopsy. A case report]. / Inyección intratumoral versus subareolar en el diagnóstico de la biopsia del ganglio centinela, en el carcinoma de mama. A propósito de un caso.

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.