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The Application of 1% Methylene Blue Dye As a Single Technique in Breast Cancer Sentinel Node Biopsy
Published on: June 1, 2019
National practice patterns of sentinel lymph node dissection for breast carcinoma
A Lucci1, P R Kelemen, C Miller
1Michael E DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
Journal of the American College of Surgeons
|April 11, 2001
Summary
Sentinel lymph node dissection (SLND) for breast cancer is widely practiced in the US with consistent techniques. However, significant variations exist in the number of procedures required before surgeons perform SLND independently.
Area of Science:
- Oncology
- Surgical Oncology
- Breast Cancer Research
Background:
- Sentinel lymph node dissection (SLND) is a key procedure for staging early breast carcinoma.
- SLND aims to prevent complications associated with complete axillary lymph node dissection (ALND).
- Current SLND techniques show significant variation, with limited guidelines for surgeon credentialing.
Purpose of the Study:
- To evaluate the current practices of SLND for breast cancer in the United States.
- To identify variations in SLND techniques and surgeon training.
Main Methods:
- A 27-item anonymous questionnaire was distributed to 1,000 randomly selected Fellows of the American College of Surgeons.
- Statistical analysis was performed on the returned questionnaires to assess current SLND practices.
Main Results:
- A 41% response rate was achieved, with 77% of respondents performing SLND for breast cancer.
- Most surgeons use preoperative lymphoscintigraphy (60%) and a combination of blue dye and radiocolloid (90%).
- Variations were noted in internal mammary lymph node removal (28%), use of immunohistochemistry/RT-PCR (80%/15%), and the number of SLND procedures performed before independent practice (28% performed ≤10).
Conclusions:
- The majority of US surgeons employ similar techniques for breast cancer SLND.
- Significant variability exists in the validation process, specifically the number of sentinel lymph node dissections (SLND) with subsequent axillary lymph node dissections (ALND) before performing SLND alone.
