Sentinel lymph node biopsy for breast cancer using methylene blue

Authors:Rama mani.L , Manohar pai, U. Anand kini.
Int J Biol Med Res. 2014; 5(1): 3793-3796  |  PDF File

Abstract

Aims & objectives : Carcinoma breast is the most common malignancy in females and is the leading cause of the death in their middle age. 1/3rd of patients present with locally advanced disease with distant metastasis at the time of their initial diagnosis . Sentinel lymph node (SLN) biopsy is a reliable and minimally invasive diagnostic method to determine the regional nodal status in breast cancer and provides accurate staging. This study to assess sentinel lymph node biopsy (SLNB) using dye alone (methylene blue) method and complications of using methylene blue such as anaphylaxis ,allergic reactions, delayed wound healing, urine discoloration were studied . Methods: 96 patients with breast cancer were subjected to SLNB (using methylene blue dye) followed by complete axillary lymph node dissection and the lymph node with positive dye was identified. The dye was injected 30 minutes prior to surgery and the stained lymph nodes were identified during dissection. The hemodynamics of the patient was assesed during and after the procedure. Patients followed up in post operative period and complications such as wound healing and urine discoloration were assesed. Results: Of 96 patients with dye injected , 69of 96 (71.87%) patients showed stained lymph node for dye. Of 69 patients with positive stain 47 patients showed evidence of malignancy. No patients had anaphylaxis or allergic reactions. 7 of 96 (7.29%) patients had delayed wound healing in post operative period requiring dressings and local treatment measures and 45 of 96(46.87%) patients had discoloration of urine. Conclusion : In our study with this method we observed there were no dye related complications and results were reliable as confirmed with intraoperative findings. SLNB can be considered in breast carcinoma as reliable cost effective and safe method for lymph node status.