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Outcome of Sentinel Lymph Node Biopsy with Methylene Blue Dye in Early-stage Breast Cancer

Received: 3 April 2021    Accepted: 21 April 2021    Published: 14 May 2021
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Abstract

Background: Axillary staging is the standard of care for all breast cancers amenable to curative treatment. Sentinel lymph node biopsy (SLNB) has been established as the gold standard for axillary staging and has supplanted axillary lymph node dissection (ALND) as a means of regional nodal staging in clinically node-negative breast cancer. Different blue dyes like isosulfan blue dye, patent blue, sulfan blue, radio labeled substances, and methylene blue dye (MBD) have been evaluated for the sentinel node procedure. Aim of the study: The aim of this study was to assess the efficacy of sentinel lymph node biopsy with methylene blue dye in clinically axillary node negative early-stage breast carcinoma as well as to observe the early postoperative outcome of SLN procedure. Method: Between November 2015 to October2017, a total of 18 female patients of 18 years and above, with diagnosis of early-stage (T1/T2) breast carcinoma with clinically negative ipsilateral axillary lymph nodes were studied in the department of surgical oncology, NICRH. Written informed consents were obtained from all patients. Results: In this study, the highest population was in 31-50 years age group with a mean age of 46(SD 12). Out of 18 cases, SLN(s) was identified in 15 cases by using MBD. The identification rate was 83.3%. In frozen section biopsy all SLNs were found positive for malignant cells. Two or more SLNs were positive in 12(66.6%) cases where SLNB was extended to ALND. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 100, 50, 80 and 100, respectively. Postoperative morbidity was significantly high in ALND group. Conclusion: This study showed that SLNB is a safe procedure and efficacy of this procedure was very significant. It lowers the unnecessary extended surgery (ALND) which has troublesome postoperative complications. Multicenter studies are required to extract more relevant information in this regard.

Published in Cancer Research Journal (Volume 9, Issue 2)
DOI 10.11648/j.crj.20210902.13
Page(s) 98-105
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Breast Cancer, MRM, Lumpectomy, BCS

References
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Cite This Article
  • APA Style

    Khandakar A. B. M. Abdullah Al Hasan, A. F. M. Anowar Hossain, Md Ashiqur Rahman, Sabiha Sultana. (2021). Outcome of Sentinel Lymph Node Biopsy with Methylene Blue Dye in Early-stage Breast Cancer. Cancer Research Journal, 9(2), 98-105. https://doi.org/10.11648/j.crj.20210902.13

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    ACS Style

    Khandakar A. B. M. Abdullah Al Hasan; A. F. M. Anowar Hossain; Md Ashiqur Rahman; Sabiha Sultana. Outcome of Sentinel Lymph Node Biopsy with Methylene Blue Dye in Early-stage Breast Cancer. Cancer Res. J. 2021, 9(2), 98-105. doi: 10.11648/j.crj.20210902.13

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    AMA Style

    Khandakar A. B. M. Abdullah Al Hasan, A. F. M. Anowar Hossain, Md Ashiqur Rahman, Sabiha Sultana. Outcome of Sentinel Lymph Node Biopsy with Methylene Blue Dye in Early-stage Breast Cancer. Cancer Res J. 2021;9(2):98-105. doi: 10.11648/j.crj.20210902.13

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  • @article{10.11648/j.crj.20210902.13,
      author = {Khandakar A. B. M. Abdullah Al Hasan and A. F. M. Anowar Hossain and Md Ashiqur Rahman and Sabiha Sultana},
      title = {Outcome of Sentinel Lymph Node Biopsy with Methylene Blue Dye in Early-stage Breast Cancer},
      journal = {Cancer Research Journal},
      volume = {9},
      number = {2},
      pages = {98-105},
      doi = {10.11648/j.crj.20210902.13},
      url = {https://doi.org/10.11648/j.crj.20210902.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.crj.20210902.13},
      abstract = {Background: Axillary staging is the standard of care for all breast cancers amenable to curative treatment. Sentinel lymph node biopsy (SLNB) has been established as the gold standard for axillary staging and has supplanted axillary lymph node dissection (ALND) as a means of regional nodal staging in clinically node-negative breast cancer. Different blue dyes like isosulfan blue dye, patent blue, sulfan blue, radio labeled substances, and methylene blue dye (MBD) have been evaluated for the sentinel node procedure. Aim of the study: The aim of this study was to assess the efficacy of sentinel lymph node biopsy with methylene blue dye in clinically axillary node negative early-stage breast carcinoma as well as to observe the early postoperative outcome of SLN procedure. Method: Between November 2015 to October2017, a total of 18 female patients of 18 years and above, with diagnosis of early-stage (T1/T2) breast carcinoma with clinically negative ipsilateral axillary lymph nodes were studied in the department of surgical oncology, NICRH. Written informed consents were obtained from all patients. Results: In this study, the highest population was in 31-50 years age group with a mean age of 46(SD 12). Out of 18 cases, SLN(s) was identified in 15 cases by using MBD. The identification rate was 83.3%. In frozen section biopsy all SLNs were found positive for malignant cells. Two or more SLNs were positive in 12(66.6%) cases where SLNB was extended to ALND. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 100, 50, 80 and 100, respectively. Postoperative morbidity was significantly high in ALND group. Conclusion: This study showed that SLNB is a safe procedure and efficacy of this procedure was very significant. It lowers the unnecessary extended surgery (ALND) which has troublesome postoperative complications. Multicenter studies are required to extract more relevant information in this regard.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Outcome of Sentinel Lymph Node Biopsy with Methylene Blue Dye in Early-stage Breast Cancer
    AU  - Khandakar A. B. M. Abdullah Al Hasan
    AU  - A. F. M. Anowar Hossain
    AU  - Md Ashiqur Rahman
    AU  - Sabiha Sultana
    Y1  - 2021/05/14
    PY  - 2021
    N1  - https://doi.org/10.11648/j.crj.20210902.13
    DO  - 10.11648/j.crj.20210902.13
    T2  - Cancer Research Journal
    JF  - Cancer Research Journal
    JO  - Cancer Research Journal
    SP  - 98
    EP  - 105
    PB  - Science Publishing Group
    SN  - 2330-8214
    UR  - https://doi.org/10.11648/j.crj.20210902.13
    AB  - Background: Axillary staging is the standard of care for all breast cancers amenable to curative treatment. Sentinel lymph node biopsy (SLNB) has been established as the gold standard for axillary staging and has supplanted axillary lymph node dissection (ALND) as a means of regional nodal staging in clinically node-negative breast cancer. Different blue dyes like isosulfan blue dye, patent blue, sulfan blue, radio labeled substances, and methylene blue dye (MBD) have been evaluated for the sentinel node procedure. Aim of the study: The aim of this study was to assess the efficacy of sentinel lymph node biopsy with methylene blue dye in clinically axillary node negative early-stage breast carcinoma as well as to observe the early postoperative outcome of SLN procedure. Method: Between November 2015 to October2017, a total of 18 female patients of 18 years and above, with diagnosis of early-stage (T1/T2) breast carcinoma with clinically negative ipsilateral axillary lymph nodes were studied in the department of surgical oncology, NICRH. Written informed consents were obtained from all patients. Results: In this study, the highest population was in 31-50 years age group with a mean age of 46(SD 12). Out of 18 cases, SLN(s) was identified in 15 cases by using MBD. The identification rate was 83.3%. In frozen section biopsy all SLNs were found positive for malignant cells. Two or more SLNs were positive in 12(66.6%) cases where SLNB was extended to ALND. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 100, 50, 80 and 100, respectively. Postoperative morbidity was significantly high in ALND group. Conclusion: This study showed that SLNB is a safe procedure and efficacy of this procedure was very significant. It lowers the unnecessary extended surgery (ALND) which has troublesome postoperative complications. Multicenter studies are required to extract more relevant information in this regard.
    VL  - 9
    IS  - 2
    ER  - 

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Author Information
  • Department of Surgical Oncology, National Institute of Cancer Research and Hospital, Mohakhali, Dhaka, Bangladesh

  • Department of Surgical Oncology, National Institute of Cancer Research and Hospital, Mohakhali, Dhaka, Bangladesh

  • Department of Surgical Oncology, National Institute of Cancer Research and Hospital, Mohakhali, Dhaka, Bangladesh

  • Department of Department of Reproductive Endocrinology and Infertility, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh

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