Preoperative tattooing of biopsied axillary node in breast cancer
Research type
Research Study
Full title
Pre-ATNEC - Preoperative tattooing of biopsied axillary node in breast cancer and correlation to sentinel lymph nodes in breast cancer patients
IRAS ID
241379
Contact name
Amit Goyal
Contact email
Sponsor organisation
Derby Teaching Hospitals NHS Foundation Trust
Duration of Study in the UK
0 years, 11 months, 30 days
Research summary
Summary of Research
Women with early breast cancer and abnormal looking lymph glands in the armpit(axilla) on ultrasound scan undergo needle biopsy of the abnormal lymph glands to check whether cancer cells are present. If the needle biopsy does not show cancer cells in the lymph glands, women undergo surgery to remove a few lymph glands in the armpit (sentinel node biopsy) to see whether the cancer has spread to the armpit as ultrasound scan is not sufficiently accurate. Currently, the abnormal lymph gland found at ultrasound scan is not marked in anyway. Therefore, we do not know for sure whether the abnormal lymph gland is removed at the time of surgery. \nIf the needle biopsy of the abnormal lymph glands shows cancer cells, women will undergo removal of all lymph glands in the armpit(axillary lymph node dissection) at the time of surgery. Axillary lymph node dissection can potentially result in arm swelling(lymphoedema), shoulder problems, sensory changes, pain and numbness. Recent research has shown that axillary lymph node dissection may be overtreatment in women with small tumours and up to 2 lymph glands with cancer spread. These women can proceed to sentinel node biopsy(removal of a few lymph glands including the lymph gland with cancer on needle biopsy) rather than axillary lymph node dissection, thus less risk of arm morbidity. However, the concern is that the biopsied node with cancer spread may be missed at sentinel node biopsy as there is no reliable way to mark that node at the time of needle biopsy, to help the surgeon visualise and remove it during surgery. \nWe are doing this study to determine whether tattooing the abnormal lymph gland with a dye at the time of needle biopsy provides a reliable and simple way for the surgeon to identify and remove it during surgery.
Summary of Results
The study found that the lymph gland in the armpit can be marked successfully with black carbon dye. The dye stains the lymph gland black and the surgeon is able to identify the tattooed lymph gland at the time of surgery. The technique is simple to learn by radiologists and surgeons and no learning curve was observed in the study. The identification rate of the tattooed node at the time of surgery was not dependent on the volume of dye injected, body mass index or timing between dye injection and surgery.
REC name
South West - Cornwall & Plymouth Research Ethics Committee
REC reference
18/SW/0097
Date of REC Opinion
18 Apr 2018
REC opinion
Further Information Favourable Opinion