Axillary Lymph Node Tattoo Marking Study

Inclusion Criteria: Any patient presenting with a new diagnosis of breast cancer or with imaging findings highly suspicious for breast cancer (BI-RADS® 4C and 5) and suspicious axillary lymph node(s) is potentially eligible. Inclusion criteria are those eligible patients who have axillary lymph node(s) that are suspicious by imaging. Evaluation of the axilla with US will be performed when clinically warranted, with lymph node sampling recommended by the radiologist based on morphologically abnormal features. * Age 18 years. Because no dosing or adverse event data are currently available on the use of Spot™ ink in participants \<18 years of age, children are excluded from this study. Patients must be able to undergo breast imaging and surgical procedures, and therefore have a ECOG performance status ≤2 (Karnofsky ≥60%). * Participants with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification. To be eligible for this trial, participants should be class 2B or better. * Women who are pregnant or lactating are eligible as Spot™ ink is placed focally in the axillary lymph node and breast tissues. * Ability to understand and the willingness to sign a written informed consent document. Exclusion Criteria: Exclusion criteria includes patients who have upper body or ipsilateral arm tattoos, as that ink may alre…