Use of the dye-guided sentinel lymph node biopsy method alone for breast cancer metastasis to avoid unnecessary axillary lymph node dissection

Abstract

For sentinel lymph node biopsy (SLNB), a combination of dye-guided and γ-probe-guided methods is the most commonly used technique. However, the number of institutes in which the γ-probe-guided method is able to be performed is limited, since special equipment is required for the method. In this study, SLNB with the dye-guided method alone was evaluated, and the clinicopathological characteristics were analyzed to identify any factors that were predictive of whether the follow-up axillary lymph node dissection (ALND) was able to be omitted. A total of 374 patients who underwent SLNB between 1999 and 2009 were studied. The SLN identification rate was analyzed, in addition to the false-positive and false-negative rates and the correlation between the clinicopathological characteristics and axillary lymph node metastases. The SLN was identified in 96.8% of cases, and, out of the patients who had SLN metastasis, 63.0% did not exhibit metastasis elsewhere. The sensitivity was 96.4% and the specificity was 100%. The false-negative rate was 3.6%. Univariate analyses revealed significant differences in the lymph vessel invasion (ly) status, nuclear grade (NG), maximum tumor size and the percentage of the area occupied by the tumor cells in the SLN (SLN occupation ratio) between the patients with and without non-SLN metastasis, indicating that these factors may be predictive of axillary lymph node metastasis. Multivariate analysis revealed that ly status was an independent risk factor for non-SLN metastasis. In conclusion, SLN with the dye-guided method alone provided a high detection rate. The study identified a predictive factor for axillary lymph node metastasis that may improve the patients’ quality of life.

The application of methylene blue coloration technique in axillary lymph node dissection of breast cancer

“…MB can be a significant guide when identifying clear lymphatic vessels and lymph nodes in ALND. Several researchers used blue dye approximately five minutes before SLNB (21,22). Sakurai et al (23) performed surgery immediately after the injection of blue dye in ARM.…”

“…Several researchers used blue dye approximately five minutes before SLNB ( 21 , 22 ). Sakurai et al ( 23 ) performed surgery immediately after the injection of blue dye in ARM.…”

Imaging methods for the local lymphatic system of the axilla in early breast cancer in patients qualified for sentinel lymph node biopsy

“…As shown in the studies conducted by Takamaru et al ., an alternative way to visualize the sentinel node in a non-radioactive manner is the use of aniline dye Patent Blue V (isosulfan) or methylene blue solution alone [ 29 ]. In a group of 374 patients subjected to surgical treatment using this procedure, the treatment was completed by resection of the node of interest in 96.8% of cases.…”

Pontes Entre Agricultura Familiar E Biológica Através Da Formação Em Contexto De Trabalho

“…A técnica de biópsia do linfonodo sentinela têm sido utilizada em grande escala em mulheres com câncer de mama em todo o mundo, por se mostrar um excelente método auxiliar diagnóstico de envolvimento dos linfonodos axilares em tumores de estágio inicial (TAKAMARU et al, 2014).…”