Purpose The most common technique for sentinel node localization is technetium-99m (Tc-99m) injection1. This is typically administered in a nuclear medicine department, causing logistical challenges in regional hospitals. This study compares outcomes of surgeon-administered injection with the nuclear medicine injection technique. Methodology Retrospective review of breast cancer patients undergoing sentinel lymph node biopsy at Tauranga Hospital between July 2021 and July 2023 was conducted. Prior to July 2022, patients travelled to a tertiary hospital for their Tc-99m injection. From July 2022, the surgical team administered the injection. Patients were excluded if neoadjuvant therapy received, axillary dissection performed due to lymph node metastases on frozen section, or if insufficient information recorded. Radioactivity signal was assessed before commencing the operation, with patent blue dye injected if no signal detected. Outcomes included blue dye requirement and number of nodes harvested. Results Eighty-five patients were included in the nuclear medicine injected group and 97 in the surgeon injected group. All patients in the surgeon injected group received Tc-99m whereas 21% of patients in the nuclear medicine injected group did not receive Tc-99m, with the primary reason being patients unable to travel. Blue dye use was significantly lower in the surgeon injected group (17.5% vs 36.0%, p = 0.004). Mean number of nodes harvested did not differ significantly (3.24 vs 3.77, p = 0.076). Conclusion Preoperative surgeon-administered Tc-99m injection improved accessibility and significantly reduced the need for blue dye without compromising sentinel node localization or lymph node yield. References 1.Bove S, Fragomeni SM, Romito A, Di Giorgio D, Rinaldi P, Pagliara D, Verri D, Romito I, Paris I, Tagliaferri L, Marazzi F, Visconti G, Franceschini G, Masetti R, Garganese G. Techniques for sentinel node biopsy in breast cancer. Minerva Surg. 2021;76(6):550–563.