Lymph-node staining with activated carbon CH40: a new method for axillary lymph-node dissection in breast cancer

Area of Science:

• Oncology
• Surgical Pathology
• Medical Imaging

Background:

• Accurate staging of breast cancer is crucial for effective treatment planning.
• Identifying axillary lymph nodes is vital for determining cancer metastasis.
• Traditional methods for lymph node detection can be insufficient, potentially leading to missed metastatic nodes.

Purpose of the Study:

• To evaluate the utility of activated carbon particles (CH40) as a vital stain for visualizing lymphatic vessels and lymph nodes in breast cancer patients.
• To assess if CH40 injection improves the detection rate of axillary lymph nodes compared to traditional methods.

Main Methods:

• A retrospective evaluation was conducted at a 716-bed teaching hospital in Japan.
• An emulsion of activated carbon particles (CH40) was injected into the mammary gland near the tumor site three days before radical surgery.
• The number of lymph nodes identified using the CH40 method was compared to the traditional method.

Main Results:

• Activated carbon particles (CH40) were readily absorbed into regional lymphatics, staining lymph nodes black.
• The CH40-guided method significantly increased the mean number of detected axillary lymph nodes per case from 8.4 (traditional) to 14.0.
• This technique facilitates easier identification of lymph nodes by both surgeons and pathologists.

Conclusions:

• Activated carbon particles (CH40) offer a cost-effective and straightforward method for enhancing lymph node visualization.
• The CH40 technique improves the accuracy of lymph node dissection and staging in breast cancer surgery.
• CH40 is recommended for detecting axillary lymph nodes when traditional methods yield insufficient results for accurate surgical assessment.