Volume 9 , Issue 2 , June 2021 , Pages: 98 - 105
Outcome of Sentinel Lymph Node Biopsy with Methylene Blue Dye in Early-stage Breast Cancer
Khandakar A. B. M. Abdullah Al Hasan, Department of Surgical Oncology, National Institute of Cancer Research and Hospital, Mohakhali, Dhaka, Bangladesh
A. F. M. Anowar Hossain, Department of Surgical Oncology, National Institute of Cancer Research and Hospital, Mohakhali, Dhaka, Bangladesh
Md Ashiqur Rahman, Department of Surgical Oncology, National Institute of Cancer Research and Hospital, Mohakhali, Dhaka, Bangladesh
Sabiha Sultana, Department of Department of Reproductive Endocrinology and Infertility, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
Received: Apr. 3, 2021;       Accepted: Apr. 21, 2021;       Published: May 14, 2021
DOI: 10.11648/j.crj.20210902.13        View        Downloads  
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.
Keywords
Breast Cancer, MRM, Lumpectomy, BCS
To cite this article
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 Research Journal. Vol. 9, No. 2, 2021, pp. 98-105. doi: 10.11648/j.crj.20210902.13
Copyright
Copyright © 2021 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[ 1 ]
Zahoor s., Altaf H., Battoo A., Qurieshi M., Wahid M., Shah M., 2017. Sentinel Lymph node Biopsy in Breast Cancer: A clinical review and update. Journal of breast cancer. September; 20 (3): 217-227. Available at: http://doi.org/10.4048/jbc.2017.20.3.217.
[ 2 ]
Rashid O. M., Takabe K., 2012. Sentinel lymph node biopsy for breast cancer: our technique and future directions in lymph node staging, Journal of Nuclear Medicine & radiation therapy. S2; 1-4.
[ 3 ]
Cody HS. Sentinel lymph node mapping in breast cancer. Breast cancer. 1999 Jan 1; 6 (1): 13-22.
[ 4 ]
Bernstein V., Hayes M., Kingston G., Poole B., Turner L., Cuddington G., 2003. Provincial guidelines for lymphatic mapping and sentinel lymph node biopsy for breast cancer. British Columbia surgical oncology network. November 21; 1-7.
[ 5 ]
Moghimi m., Ghoddosi I., Rahimabadi A. E., Sheikhvatan M., 2009. Accuracy of sentinel node biopsy in breast cancer patients with high prevalence of axillary metastasis. Scandinavian journal of surgery, 98; 30-33.
[ 6 ]
Cox C. E., Pendas S., Cox J. M., Joseph E., Shons R. A., Yeatman T., 1998. Guidelines for sentinel node biopsy and lymphatic mapping of patiens with breast cancer. Annals of surgery, 227 (5), -653.
[ 7 ]
Somasundaram s. k., chiken D. W., Keshtgar M. R. S. 2007. Detection of sentinel lymph node in breast cancer. British Medical bulletin; 84: 117-131.
[ 8 ]
Rosso K. J., Nathansom S. D., 2015. Techniques that accurately identify the sentinel lymph node in cancer. World journal of surgical procedures. March 28; 5 (1): 14-26. [online]. Available at: http://www.wjgnet/2219-2831/full/v5/il/14.
[ 9 ]
Morton DL, Wen DR, Wong JH et al. 1992. Technical details of intraoperative lymphatic mapping for early-stage melanoma. Arch Surgery; 127, 392–399.
[ 10 ]
Mansel RE, Fallowfield L, Kissin M., 2006. Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer: The Almanac Trial. J Natl Cancer Inst; 98: 599-609.
[ 11 ]
Veronesi U, Paganelli G, Viale G, Luini A, Zurrida S, Galimberti V, Intra M, Veronesi P, Maisonneuve P, Gatti G, Mazzarol G, De CC, Manfredi G, Fernandez JR., 2006. Sentinel-lymph-node biopsy as a staging procedure in breast cancer: update of a randomised controlled study. Lancet Oncol 7 (12): 983 – 990.
[ 12 ]
Canavese G. et al (2008). Sentinel node biopsy compared with complete axillary dissection for staging early breast cancer with clinically negative lymph nodes: results of randomized trial. Annals of oncology, 20: 1001-1009.
[ 13 ]
Gill G., et al., 2009. Sentinel-lymph-node-based management or routine axillary clearance? One-year outcomes of sentinel node biopsy versus axillary clearance (SNAC): a randomized controlled surgical trial. Ann Surg Oncol 16 (2): 266 – 275.
[ 14 ]
Krag D. N., Anderson S. J., Jullian T. B., Brown A. M., Harlow S. P., wolkmark N., 2010. Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial. Lancet oncology journal. 11 (10), 927-933.
[ 15 ]
Veronesi U, Paganelli G, Galimberti V, et al., 1997. Sentinel-node biopsy to avoid axillary dissection in breast cancer with clinically negative lymph nodes. Lancet; 349 (9069): 1864–7.
[ 16 ]
Giuliano A. E., Kirgan D. M., Guenther J. M., Morton D. L., 1994. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Annals of surgery. 220 (3), 391-401.
[ 17 ]
Mathelin C, Croce s., Brasse D., Gairard B., Gharbi M., Andriamisandratsoa N., Bekeart V., et al., 2009. Methylene blue dye, an accurate dye for sentinel lymph node identification in early breast cancer. Anticancer research. 29:4119-4126.
[ 18 ]
Tsopelas C., Sutton R., 2002. Why certain dyes are useful for localizing the sentinel lymph node. Journal of nuclear medicine. 43 (10), 1377-1381.
[ 19 ]
Simmons R. M., Smith S. M. and Osborne M. P., 2001. Methylene blue dye as an alternative to isosulfan blue dye for sentinel lymph node localization. The Breast Journal. 7, 181-183.
[ 20 ]
Mukherjee A, Kharkwal S, Charak KS. Assessment of the efficacy and safety of methylene blue dye for sentinel lymph node mapping in early breast cancer with clinically negative axilla. Archives of International Surgery. 2014 Jan 1; 4 (1): 6.
[ 21 ]
Hussain SA, Sullivan R. Cancer control in Bangladesh. Japanese journal of clinical oncology. 2013 Dec 1; 43 (12): 1159-69.
[ 22 ]
Rahman M., Ahsan A., Begum F., Rahman K., 2015. Epidemiology, Risk factor and tumour profilesof Breast cancer in Bangladeshi underprivileged women. The Gulf journal of oncology. ISSN. 2078-2101.
[ 23 ]
Pervin M. M., Nath H. D., Bahar M. M., Alam A., Bhowmic J., 2014. Study on clinical presentation of breast carcinoma of 50 cases. Chattagram Maa-o-Shishu Hospital Medical College Journal. 13 (2), 8-11.
[ 24 ]
Hossain M S., Ferdous S., Karim Kos H E. (2014). Breast cancer in South Asia: A Bangladeshi Prtspective. The International Journal of of cancer epidemiology, Detection and prevention. [ONLINE] available at: http://www.dx.doi.org/10.1016/j.canep.2014.08.004.
[ 25 ]
Ozsoy A., et al., (2017). The relationship between breast cancer and risk factors: a single centre study. Eur. Journal of Breast Health. 13: 145-149.
[ 26 ]
Palmer JR, Wise LA, Hatch EE, Troisi R, Titus-Ernstoff L, Strohsnitter W, Kaufman R, Herbst AL, Noller KL, Hyer M, Hoover RN. Prenatal diethylstilbestrol exposure and risk of breast cancer. Cancer Epidemiology and Prevention Biomarkers. 2006 Aug 1; 15 (8): 1509-14.
[ 27 ]
Alwan NA. Breast cancer: demographic characteristics and clinico-pathological presentation of patients in Iraq. EMHJ-Eastern Mediterranean Health Journal, 16 (11), 1159-1164, 2010. 2010.
[ 28 ]
Nowikiewicz T. et al., (2015). Diagnostic value of preoperative axillary lymph node ultrasound assessment in patients with breast cancer qualified for sentinel lymph node biopsy. Videosurgery Miniinv; 10 (2): 170-172.
[ 29 ]
Ashturkar AV, Pathak GS, Deshmukh SD, Pandave HT. Factors Predicting the Axillary Lymph Node Metastasis in Breast Cancer: Is Axillary Node Clearance Indicated in Every Breast Cancer Patient? Indian Journal of Surgery. 2011 Oct 1; 73 (5): 331-5.
[ 30 ]
Georgette SW et al. (2004). Correlation between breast tumour size and level of the axillary lymphnode involvement. Asian journal of surgery. 28 (2): 97-99.
[ 31 ]
Ratchawarapong K et al., (2014). Rate of sentinel lymphnode identification using isosulphan blue dye in breast cancer patients at Charoenkrung Pracharak Hospital, Thailand. Journal of Asian Biomedicine, 8 (4): 517-524.
[ 32 ]
Albertini JJ, Lyman GH, Cox C, Yeatman T, Balducci L, Ku N, Shivers S, Berman C, Wells K, Rapaport D, Shons A. Lymphatic mapping and sentinel node biopsy in the patient with breast cancer. Jama. 1996 Dec 11; 276 (22): 1818-22.
[ 33 ]
Lucci A. et al., (2007). Surgical complications associated with sentinel lymphnode dissection (SLND) plus axillary lymphnode dissection compared with SLND alone in the Americal College of Surgeons oncology group trial Z0011. Journal of cli.onco., 25 (24): 3657-3663.
Browse journals by subject