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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
Processing sentinel nodes in breast cancer: when and how many?
Samer Schuman1, Gail Walker, Eli Avisar
1Division of Gynecologic Oncology, University of Miami-Miller School of Medicine, 1475 NW 12th Ave, Sylvester Comprehensive Cancer Center 3500, Miami, FL 33136, USA. sschuman@med.miami.edu
Archives of Surgery (Chicago, Ill. : 1960)
|April 20, 2011
Summary
Analyzing sentinel nodes (SNs) in breast cancer patients shows that examining the two hottest nodes and suspicious nodes is effective for initial staging. Further analysis of additional nodes is only needed if nodal disease is detected.
Area of Science:
- Oncology
- Surgical Pathology
Background:
- Sentinel node biopsy is crucial for staging breast cancer.
- Accurate staging of breast cancer relies on precise sentinel node analysis.
Purpose of the Study:
- To evaluate the diagnostic value of sentinel nodes (SNs) in node-positive breast cancer.
- To establish an effective algorithm for SN analysis.
- To assess the clinical utility of current SN biopsy practices.
Main Methods:
- Analysis of a prospectively collected database of 105 patients with node-positive breast cancer.
- Evaluation of sentinel nodes (SNs) based on radioactivity (hottest, 2 hottest), blue dye staining, and suspicious morphology.
- Calculation of diagnostic sensitivity for different combinations of SN analysis.
Main Results:
- The most radioactive node identified nodal disease in 77.7% of patients.
- Analyzing the two most radioactive nodes increased sensitivity to 90.4% (P < .001).
- Considering all radioactive, blue, and suspicious nodes improved sensitivity to 96.2% (P = .002).
Conclusions:
- Processing the two hottest nodes and suspicious nodes is adequate for initial axillary staging.
- Further processing of additional radioactive sentinel nodes is recommended only when nodal disease is confirmed.
