Validation sentinel lymph node biopsy study in cN0 axilla using low-cost dual dye technique: potential solution for resource poor settings.

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Tytuł:: Validation sentinel lymph node biopsy study in cN0 axilla using low-cost dual dye technique: potential solution for resource poor settings.
Autorzy:: Chavda J; Department of Surgery, Netaji Subhash Chandra Bose (NSCB) Medical College, Jabalpur, India.
Mishra A; Department of Surgery, Netaji Subhash Chandra Bose (NSCB) Medical College, Jabalpur, India.
Silodia A; Department of Surgery, Netaji Subhash Chandra Bose (NSCB) Medical College, Jabalpur, India.
Yadav SK; Department of Surgery, Netaji Subhash Chandra Bose (NSCB) Medical College, Jabalpur, India. .
Sharma DB; Department of Surgery, Netaji Subhash Chandra Bose (NSCB) Medical College, Jabalpur, India.
Sharma D; Department of Surgery, Netaji Subhash Chandra Bose (NSCB) Medical College, Jabalpur, India.
Khandare M; Department of Pathology, Netaji Subhash Chandra Bose (NSCB) Medical College, Jabalpur, India.
Źródło:: Breast cancer research and treatment [Breast Cancer Res Treat] 2022 May; Vol. 193 (1), pp. 105-110. Date of Electronic Publication: 2022 Mar 05.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: Dordrecht : Kluwer Academic
Original Publication: The Hague ; Boston : M. Nijhoff, c1981-
MeSH Terms:: Breast Neoplasms*/diagnosis
Breast Neoplasms*/drug therapy
Breast Neoplasms*/surgery
Sentinel Lymph Node*/diagnostic imaging
Sentinel Lymph Node*/pathology
Sentinel Lymph Node*/surgery
Axilla/pathology ; Coloring Agents ; Cross-Sectional Studies ; Female ; Fluorescein/therapeutic use ; Humans ; Lymph Node Excision ; Lymph Nodes/pathology ; Neoadjuvant Therapy ; Pharmaceutical Preparations ; Sentinel Lymph Node Biopsy
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Contributed Indexing:: Keywords: Breast cancer; Low-cost; Sentinel lymph node biopsy
Substance Nomenclature:: 0 (Coloring Agents)
0 (Pharmaceutical Preparations)
TPY09G7XIR (Fluorescein)
Entry Date(s):: Date Created: 20220305 Date Completed: 20220412 Latest Revision: 20220412
Update Code:: 20240105
DOI:: 10.1007/s10549-022-06556-w
PMID:: 35246773
: Czasopismo naukowe

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Background: Sentinel lymph node biopsy (SLNB) using radio-pharmaceutical and a blue dye is gold standard for axillary staging in clinically node-negative breast cancer. High costs and limited availability of radio-pharmaceutical and/or gamma probe are major deterrents in performing SLNB in developing countries. In this study, we evaluated feasibility of SLN identification (SLN-IR) of fluorescein-guided (FG) SLNB in combination with methylene blue dye (MBD).
Methods: This was a prospective cross-sectional non-randomized validation study in patients with clinically node-negative axilla. Patients underwent validation SLNB using fluorescein (and blue LED light) and MBD. Axillary dissection was performed irrespective of SLNB histology. SLIN-IR and False Negative Rate (FNR) were assessed for both groups.
Results: The SLNs were identified in 29 (96.6%) pre-chemotherapy patients and 23 (82%) post Neoadjuvant Chemotherapy (NACT) patients. The median number of sentinel lymph nodes identified was 3 (range of 1-5) in pre-chemotherapy patients and 1 (range of 1-3) in post NACT patients. The SLN-IR using MBD was 90%, FD was 86.7% and combined MBD FD was 96.7% in pre-chemotherapy patients. The SLN-IR using MBD was 82%, FD was 71% and combined MBD FD was 82% in in post NACT patients. The false negative rate (FNR) in pre-chemotherapy group was 8.0% (MBD), 8.3% (FD) and 7.4% (MBD + FD). The FNR in post NACT group was 8.7% (MBD), 10% (FD) and 8.7% (MBD + FD).
Conclusion: This prospective validation study showed adequate SLN-IR and FNR using low-cost dual dyes in early breast cancer patients and can be used in low resource settings. However, SLNB in post NACT axilla though viable along with a satisfactory FNR, is associated with low identification rate and needs further evaluation.
(© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

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