Feasibility of Preoperative Tattooing of Percutaneously Biopsied Axillary Lymph Node: A Quasi Experimental Pilot Study

Inclusion Criteria: * Breast cancer patient (biopsy proven or clinically suspected) with clinically suspicious (palpable on clinical exam or abnormal by ultrasound criteria but not biopsied yet) ipsilateral axillary lymph node(s). The ultrasonographic examination will be considered suspicious for metastasis if one or more of following criteria are present: 1. Eccentric cortical enlargement (\>3 mm) or lobulation with displacement of hilum 2. Absent hilum and irregular border and hypoechoic echotexture 3. Spherical node 4. Perinodal vascularity. (18-20) * Participants willing to undergo axillary lymph node percutaneous biopsy with marking/tattooing of the biopsied lymph node at AKUH * Participants intending to have definitive surgery at AKUH Exclusion Criteria: * Participants with terminal disease like renal failure will be excluded because these conditions can have profound effect on their course of treatment * Participants with distant metastases * Participants with prior breast or axillary surgery * Participants with bilateral breast cancer, and those who have already had an axillary core needle biopsy prior to inclusion (to avoid a second procedure for tattooing) * Participants with recurrent breast malignancy because their course of treatment might be different * Participants that were initially suspected to have breast cancer, but pathology results did not confirm the diagnosis * Pregnant and lactating women * Men with breast cancer