A dose of 63.6 MBq (1.6 mCi) 99mTc-nanocolloid in a volume of 0.32 mL was injected intradermally around the biopsy scar. Lymphoscintigraphy showed drainage across the midline to one sentinel node in the left axilla (Fig. 9). A second-tier node was depicted a little higher up. There was also drainage to two nodes in the internal mammary chain but not to the ipsilateral axilla.
The operation was performed with the aid of vital dye and a gamma-ray detector. Two lymphatic vessels in the left axilla were observed and easily traced to the blue and radioactive sentinel node. The second-tier node was not disturbed. The internal mammary sentinel nodes could not be reached without dividing a rib. The surgeon was not prepared to do that for what he considered to be an experimental procedure.
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