AndleebKhanam, HurriatAfzal, Yaseen Rafi, Aslam H, Khwaja K
Pakistan Journal of Medical & Health Sciences




Peer Reviewed

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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.



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