Identification of the sentinel lymph node in the SNAC-1 trial

Abstract

The combined technique resulted in a high identification rate. BD contributed to the identification of the SLNs in patients where LSG and GP failed to identify the sentinel node. Special attention to these techniques is needed in particular groups of patients such as those with high BMI, screen-detected primary tumours and tumour located in the inner quadrants.

Sentinel lymph node biopsy in breast cancer

“…To maximize our SN identification rate, we used the dual method (radioactive tracer and patent blue dye). 25 - 29 Our identification rate was 97.6%, which is in accordance with most of the published literatures. 26 , 27 , 30…”

The combination of blue dye and radioisotope versus radioisotope alone during sentinel lymph node biopsy for breast cancer: a systematic review

“…For 7 studies with a high proportion (≥90 %) [ 1 , 3 , 10 , 11 , 25 , 29 , 30 ], the pooled data revealed no statistically significant difference between dual tracers and radioisotope alone (OR = 1.41, 95 % CI 0.83–2.39, P > 0.05). For 6 studies with a relatively low proportion (<90 %) [ 19 , 21 – 23 , 26 , 31 ], the advantage of using dual tracers was statistically significant (OR = 2.99, 95 % CI 1.99–4.48, P > 0.05) (Table 3 ).…”

“…Kuehn et al reported both data for patients before NAC and those after NAC, which were extracted separately [ 3 ]. For 6 studies including patients before NAC [ 1 , 3 , 11 , 21 , 31 , 34 ], the combined use of blue dye and radioisotope showed higher identification rate than radioisotope alone (OR = 2.96, 95 % CI 1.78–4.94, P < 0.05; I 2 = 15.6 %). For 3 studies including patients after NAC [ 3 , 20 , 27 ], no statistically significant difference was revealed when comparing dual tracers with radioisotope alone (OR = 1.53, 95 % CI 0.94–2.47, P > 0.05; I 2 = 31.6 %) (Table 3 ).…”

“…Of the 24 publications, no study reported adverse episodes for the use of radioisotope. In contrast, 4 studies reported allergic reactions to blue dye [ 1 , 10 , 11 , 21 ]. Most patients experienced mild allergic reactions.…”

“…The recent RCT failed to demonstrate an advantage with the addition of blue dye to radioisotope alone in patients before NAC with positive preoperative LSG [ 11 ]. LSG is a useful tool to establish abnormal lymphatic drainage patterns, and to detect extra-axillary nodes particularly internal mammary nodes [ 21 , 24 , 30 ]. It is an integral part of single radioisotope tracer during SLNB.…”