Influence of Imaging Features and Technique on US-guided Tattoo Ink Marking of Axillary Lymph Nodes Removed at Sentinel Lymph Node Biopsy in Women With Breast Cancer

Abstract Objective To describe tattoo ink marking of axillary lymph nodes (TIMAN) and the elements leading to successful removal at sentinel node biopsy (SLNB). Methods An IRB-approved retrospective image review was conducted breast cancer patients who underwent SLNB after TIMAN from February 2013 August 2017, noting patient tattooed (TLN) features, initial type, time surgery, if TLN identified correlation with SLN. Cases were divided into two groups: presurgical group, which had primary pre-neoadjuvant chemotherapy (NACT) surgery completing NACT. Results Of 30 32 procedures, 10 (33.3%) 20 (66.7%) pre-NACT. The average (LN) depth skin 1.6 cm, an 0.3 mL injected. 29 (90.6%) US images demonstrating injection. these, (34.5%) injected in LN cortex surface 19 (65.5%) middle cortex. Seven (24.1%) lateral aspect, 12 (41.4%) mid medial aspect. LNs, 28 (87.5%) immediately 4 (12.5%) a later date. At SLNB, all (100%) TLNs identified, correlated SLN, (31.3%) positive for cancer. Conclusion Using ink, successfully despite variability injection factors.