چکیده (انگلیسی):

Background: Inappropriate skin incisions can make sentinel lymph node dissection
difficult. A knowledge of the most common locations of the hotspot in the axilla helps in planning
the incision. This information also helps to locate the lymph node preoperatively by ultrasound.
The aim of this prospective study was to determine the most common location of the
sentinel lymph node in the axilla.
Methods: From January 2006 to December 2010, 974 consecutive patients who underwent
sentinel lymph node dissection guided by 99mTcesulfur colloid were included and the position
of the hotspot in the axilla was recorded prospectively. The location of the hottest spot on the
skin of the axilla was categorized into seven areas divided by five landmarks.
Results: In 98.4% of our patients, the hotspot detected on the axilla skin before sentinel lymph
node dissection was located in the area demarcated by the four landmarks of the hairline, a
line tangential to and 2 cm below the center of the hairline, the lateral border of the pectoralis
major muscle, and the mid-axillary line.
Conclusion: The area between these four landmarks is the most frequent location of the
sentinel lymph node identified using the radioisotope method. We suggest that this area should
be carefully evaluated preoperatively by ultrasound for appropriate surgical planning. A skin
incision in this area is also recommended when sentinel lymph node dissection is guided by
blue dye.