Goyal, Amit, Puri, Shama, Marshall, Andrea, Valassiadou, Kalliope, Hoosein, Moin M., Carmichael, Amtul R., Erdelyi, Gabriella, Sharma, Nisha, Dunn, Janet A. and York, Joanne (2020) A multicentre prospective feasibility study of carbon dye tattooing of biopsied axillary node and surgical localisation in breast cancer patients. Breast Cancer Research and Treatment . doi:10.1007/s10549-020-05961-3 (In Press)

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Abstract

Background
The primary aim of this prospective, multicentre feasibility study was to determine whether the biopsied axillary node can be marked using black carbon dye and successfully identified at the time of surgery.

Methods
We included breast cancer patients undergoing needle biopsy of the axillary node. The biopsied node was tattooed at the time of needle biopsy (fine needle aspiration or core biopsy) or at a separate visit with black carbon dye (Spot® or Black Eye™). Participants underwent primary surgery or neoadjuvant chemotherapy (NACT) and axillary surgery (SNB or ALND) as per routine care.

Results
110 patients were included. Median age of the women was 59 (range 31–88) years. 48 (44%) underwent SNB and 62 (56%) ALND. Median volume of dye injected was 2.0 ml (range 0.2–4.2). Tattooed node was identified intra-operatively in 90 (82%) patients. The identification rate was higher (76 of 88, 86%) in the primary surgery group compared with NACT (14 of 22, 64%) (p = 0.03). Of those undergoing NACT, the identification rate was better in the patients undergoing SNB (3 of 4, 75%) compared with ALND (11 of 18, 61%) (p > 0.99). The tattooed node was the sentinel node in 78% (28 of 36) patients in the primary surgery group and 100% (3 of 3) in the NACT group. There was no learning curve for surgeons or radiologists. The identification rate did not vary with timing between dye injection and surgery (p = 0.56), body mass index (p = 0.62) or volume of dye injected (p = 0.25).

Conclusion
It is feasible to mark the axillary node with carbon dye and identify it intra-operatively.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine R Medicine > RD Surgery R Medicine > RG Gynecology and obstetrics
Divisions:	Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Breast -- Cancer , Breast -- Cancer -- Surgery, Breast -- Needle biopsy, Breast -- Cancer -- Imaging , Temporary tattoos -- Medical examination, Breast -- Cancer -- Treatment
Journal or Publication Title:	Breast Cancer Research and Treatment
Publisher:	Springer
ISSN:	0167-6806
Official Date:	6 October 2020
Dates:	Date Event 6 October 2020 Published 29 September 2020 Accepted
Date of first compliant deposit:	14 October 2020
DOI:	10.1007/s10549-020-05961-3
Status:	Peer Reviewed
Publication Status:	In Press
Access rights to Published version:	Restricted or Subscription Access

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