scholarly journals Preoperative Axillary Ultrasound-guided Wire Localization and Lymphoscintigraphy for Sentinel Lymph Node Biopsy in Breast Cancer Patients

2021 ◽  
Author(s):  
Fezzeh Elyasinia ◽  
Homa Hemmasi ◽  
Karamollah Toolabi ◽  
Afsaneh Alikhassi ◽  
Mehran Sohrabi Maralani ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Methylene Blue ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Cancer Patients ◽  
Blue Dye ◽  
Methylene Blue Dye ◽  
Breast Cancer Patients ◽  
Wire Localization ◽  
Ultrasound Guided

Background: Breast cancer has the highest incidence and mortality among female malignant tumors. Breast cancer with negative axillary lymph nodes has been diag- nosed mainly at an early stage. Sentinel lymph node biopsy (SLNB) is a standard screening technique for patients with early-stage breast cancer and clinically nega- tive lymph nodes. Lymphoscintigraphy (sentinel lymph node mapping) has been reg- ularly used as the standard method for SLNB. Today, ultrasound-guided wire locali- zation (USGWL) is a well-established technique with superior outcomes. Therefore, we attempted to determine whether preoperative UGWL and lymphoscintigraphy (blue dye and isotope injection) improve SLN detection and false-negative rate in breast cancer patients undergoing SLNB and identify clinical factors that may affect the diagnostic accuracy of axillary ultrasound (AUS). Methods: Between December 2018 and June 2019, 55 patients with clinical T1- 3N0 breast cancer eligible for an SLNB at Imam Khomeini Hospital in Tehran were included in our study. Tumor characteristics and demographic data were collect- ed by reviewing medical records and questionnaires prepared by our surgical team. The day before SLNB, all patients underwent ultrasound-guided wire localization of SLN. Lymphoscintigraphy was performed with an unfiltered 99mTc-labelled sulfur colloid peritumoral injection followed by methylene blue dye injection. The results were analyzed based on the permanent pathology report. Results: Among the 55 patients, 71.8% of SLNs were detected by wire localization, while 57.8% were found by methylene blue mapping and 59.6% by gamma probe detection. Compared with wire localization and isotope injection, the methylene blue dye technique had a low sensitivity (72.2%), while both wire localization and isotope injection reached 77.8%. The sensitivity, specificity, and accuracy of UGWL were 77.8%, 42.1%, and 65.4%, respectively. Otherwise, methylene blue dye and isotope injection accuracy was 47.3% and 50.1%, respectively. Furthermore, there was a significant relationship between BMI, tumor size, laterality, reactive ALN, and the accuracy of preoperative AUS. But there was no significant correlation between age, weight, height, tumor biopsy, tumor location, the time interval between methylene blue dye and isotope injection to surgery, and also the type of surgery to the accuracy of preoperative AUS. Conclusion: Preoperative UGWL can effectively identify SLNs compared to lym- phoscintigraphy (blue dye and isotope injection) in early breast cancer patients un- dergoing SLNB.

scholarly journals Rate of sentinel lymph node identification using isosulfan blue dye in breast cancer patients at Charoenkrung Pracharak Hospital, Thailand

2014 ◽  
Vol 8 (4) ◽  
pp. 517-524
Author(s):  
Kampol Ratchaworapong ◽  
Sarawut Thanawut ◽  
Sirisanpang Yodavudh ◽  
Suthat Chottanapund
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Cancer Patients ◽  
Primary Breast Tumor ◽  
Blue Dye ◽  
Axillary Lymph ◽  
Isosulfan Blue ◽  
Breast Cancer Patients ◽  
Isosulfan Blue Dye

Abstract Background: The sentinel lymph node (SLN) is the first lymph node to receive lymphatic drainage from a primary breast tumor. If the SLN contains no metastatic tumor, then it is unlikely other lymph nodes will contain breast cancer metastasis. When the SLN does contains metastasis, an axillary lymph node dissection (ALND) is recommended to further stage the axilla and to maintain locoregional control. SLNs can be identified by using a dye, radioisotope, or combined techniques. Objective: To determine the rate of SLN identification using isosulfan blue dye in breast cancer patients at Charoenkrung Pracharak Hospital, Thailand, and factors that affect it. Methods: This prospective study of 106 consecutive cases breast cancer enrolled 105 women (1 bilateral breast cancer case) between October 2011 and October 2013 at Charoenkrung Pracharak Hospital. Clinical and pathological features were analyzed for the effectiveness of SLN identification using isosulfan blue dye. Results: The rate of SLN identification using isosulfan blue dye in breast cancer patients at Charoenkrung Pracharak Hospital was 92%. The method was safe and well tolerated in early-stage breast cancer patients. Conclusion: The effectiveness of sentinel node identification using isosulfan blue dye in breast cancer patients at Charoenkrung Pracharak Hospital is consistent with that shown in studies from other countries.

scholarly journals Factors that affect the false negative rate of sentinel lymph node mapping with methylene blue dye alone in breast cancer

2019 ◽  
Vol 47 (10) ◽  
pp. 4841-4853 ◽  
Author(s):  
Huang Li ◽  
Zhang Jun ◽  
Ge Zhi-Cheng ◽  
Qu Xiang
Keyword(s):  
Breast Cancer ◽  
Methylene Blue ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
False Negative ◽  
False Negative Rate ◽  
Blue Dye ◽  
Methylene Blue Dye ◽  
Clinicopathological Factors

Objective This study aimed to investigate the clinicopathological factors of the false negative rate (FNR) and accuracy of sentinel lymph node biopsy (SLNB) mapping with 1% methylene blue dye (MBD) alone, and to examine how to reduce the FNR in patients with breast cancer. Methods A total of 365 patients with invasive breast carcinoma who received axillary lymph node dissection after SLNB were retrospectively analyzed. SLNB was performed with 2 to 5 mL of 1% MBD. We studied the clinicopathological factors that could affect the FNR of SLNB. Results The identification rate of sentinel lymph nodes (SLNs) was 98.3% (359/365) and the FNR of SLNB was 10.4% (16/154). Multivariate analysis showed that the number of dissected SLNs and metastatic lymph nodes were independent predictive factors for the FNR of SLNB. The FNR in patients with 1, 2, 3, and ≥4 SLNs was 23.53%, 15.79%, 3.85%, and 1.79%, respectively. Conclusions SLNB mapping with MBD alone in patients with breast cancer can produce favorable identification rates. The FNR of SLNB decreases as the number of SLNs rises. Because of side effects of searching for additional SLNs and the FNR, removal of three or four SLNs may be appropriate.

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