Operative Findings
At operation, the site of the sentinel node was
confirmed with Neoprobe 1500 prior to incision.
Through a 2.5-cm incision, the axilla was explored
and with a 14-mm probe; the sentinel node was
easily localised. The patient underwent wide local
excision of the primary tumour.
A 79-year-old female presented with a lump in the
left breast. On examination, there was a 2-cm
mobile lump in the upper outer quadrant of the
breast. There was no clinical evidence of axillary
node involvement. Pre-operative investigation
confirmed the diagnosis of mucinous carcinoma.
Considering the patient’s age and the good prog-
nosis of the tumour, she underwent wide local
excision and sentinel node biopsy only.
Dynamic Imaging
case
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Mucinous Breast Carcinoma
Dynamic imaging failed to show a lymphatic tract
and towards the end of dynamic acquisition a
focal area of radioactivity uptake was evident
very close to the injection site.
Static Imaging
Prior to static acquisition, the breast was retract-
ed downwards and medially to prevent the mask-
ing of the sentinel node from the injection site.
An area of increased focal uptake was then clearly
demonstrated in the axilla. The overlying skin
was marked.
Histology
Histology confirmed a grade 1 mucinous carci-
noma measuring 2 cm in its maximum dimen-
sion. The sentinel node was free of metastatic
tumour on H & E staining and immunohisto-
chemistry. Oestrogen receptor status was positive.
Teaching Point
This case demonstrates that in elderly patients with a good-prognosis early breast carcinoma, senti-
nel node biopsy can be considered. This may avoid morbidity associated with an axillary node
clearance in a low-risk case.
