Management of Axilla in Early Breast Cancer by Sentinel Lymph Node Biopsy Using Blue Dye
AndleebKhanam, HurriatAfzal, Yaseen Rafi, Aslam H, Khwaja K
472
ABSTRACT
Background: Axillary lymph node dissection for staging of axilla in early breast
cancer is associated with morbidity like painful arm, stiffness of shoulder
joint and odema of the arm. Sentinel lymph node biopsy selectively removes the first
node draining from the primary tumour. Axillary lymph node involvement is a
very good prognostic indicator in breast cancer. Unnecessary axillary
dissection in these patients can avoid these complications by doing sentinel
lymph node biopsy.
Aim: To find out
the accuracy and complications in sentinel lymph node biopsy by using methylene
blue dye in early breast cancer.
Methods: Study
design: case series conducted from April
2018 to August 2019 at Sir Ganga Ram Hospital Lahore. Sampling
technique used was purposive simple random technique. Sample size was 54 patients
with diagnosis of breast carcinoma were selected having impalpable axillary nodes on clinical
examination. Sentinel lymph node biopsy was performed by using 1% Methylene
blue dye subcutaneously at 12 o clock or
6 O clock position. Small separate skin
crease incision was given in axilla in case of breast conservative surgery or
in modified radical mastectomy same incision was used.
Results: Mean
age of the patients was 47 years SD 10.3+-. Most of the patients were married
94.5 % and only 5.5% were unmarried. It was stage I in 35 % and stage II in 64%.
Breast conservative surgery was performed in 72% and modified radical
mastectomy in 27% patients. Sentinel lymph nodes were stained in 96% cases.Metastasis
were found in 31%cases and no metastasis in 64% nodes only in 0.03% cases nodes
were not stained. Accuracy of SLNB with methylene blue dye was determined after
final histopathological report showing same status of axilla in 96% cases.
Complications with sentinel lymph node biopsy were seen only in 0.09%cases
which were minor.
Conclusion: Sentinel lymph node biopsy technique by using methylene blue dye can
safely be done in patients with early breast carcinoma having impalpable nodes.
Unnecessary axillary dissection can be avoided in these patients which is
associated with postoperative morbidity.
Keywords:
Sentinel lymph nodebiopsy, modified radical mastectomy, breast conservative
surgery.
ABSTRACT
Background: Axillary lymph node dissection for staging of axilla in early breast
cancer is associated with morbidity like painful arm, stiffness of shoulder
joint and odema of the arm. Sentinel lymph node biopsy selectively removes the first
node draining from the primary tumour. Axillary lymph node involvement is a
very good prognostic indicator in breast cancer. Unnecessary axillary
dissection in these patients can avoid these complications by doing sentinel
lymph node biopsy.
Aim: To find out
the accuracy and complications in sentinel lymph node biopsy by using methylene
blue dye in early breast cancer.
Methods: Study
design: case series conducted from April
2018 to August 2019 at Sir Ganga Ram Hospital Lahore. Sampling
technique used was purposive simple random technique. Sample size was 54 patients
with diagnosis of breast carcinoma were selected having impalpable axillary nodes on clinical
examination. Sentinel lymph node biopsy was performed by using 1% Methylene
blue dye subcutaneously at 12 o clock or
6 O clock position. Small separate skin
crease incision was given in axilla in case of breast conservative surgery or
in modified radical mastectomy same incision was used.
Results: Mean
age of the patients was 47 years SD 10.3+-. Most of the patients were married
94.5 % and only 5.5% were unmarried. It was stage I in 35 % and stage II in 64%.
Breast conservative surgery was performed in 72% and modified radical
mastectomy in 27% patients. Sentinel lymph nodes were stained in 96% cases.Metastasis
were found in 31%cases and no metastasis in 64% nodes only in 0.03% cases nodes
were not stained. Accuracy of SLNB with methylene blue dye was determined after
final histopathological report showing same status of axilla in 96% cases.
Complications with sentinel lymph node biopsy were seen only in 0.09%cases
which were minor.
Conclusion: Sentinel lymph node biopsy technique by using methylene blue dye can
safely be done in patients with early breast carcinoma having impalpable nodes.
Unnecessary axillary dissection can be avoided in these patients which is
associated with postoperative morbidity.
Keywords:
Sentinel lymph nodebiopsy, modified radical mastectomy, breast conservative
surgery.