Methylene Blue as Inexpensive and Reliable Sole Sentinel Lymph Node Mapping Agent for Patients with Invasive Ductal Carcinoma.
Breast cancer
SLNB
lymph nodes mapping
methylene blue
sentinel lymph nodes
Journal
Materia socio-medica
ISSN: 1512-7680
Titre abrégé: Mater Sociomed
Pays: Bosnia and Herzegovina
ID NLM: 101281595
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
15
09
2021
accepted:
28
11
2021
entrez:
25
2
2022
pubmed:
26
2
2022
medline:
26
2
2022
Statut:
ppublish
Résumé
Invasive ductal cancer (IDC) represents about 75% of all breast malignancies. There are many breast cancer prognostic factors, but the ones that have the most impact on the survival rates in advanced breast cancer are tumor size and regional lymph node involvement. Axillary lymph node dissection (ALND) has particularly important and undoubtful role in current surgical options for breast cancer treatment. With the introduction of sentinel lymph node biopsy (SLNB) for breast cancer patients it was possible to identify those to whom regional spread of the disease did not occur at the time of surgery, and thus spare them an unnecessary ALND procedure. To determine the rate of sentinel lymph node (SLN) detection using only methylene blue dye as a mapping agent, as well as to correlate the number of positive SLNs with the number of positive non-sentinel lymph nodes (non-SLNs). The study represents a prospective study that included 50 female patients with histologically confirmed invasive ductal carcinoma (IDC) who underwent SLNB using only methylene blue dye as the mapping agent, while the detection and harvest of SNL was done by visual control only. All patients also underwent an obligatory complete ALND, which was as that time the institutional oncological protocol for surgical treatment of histologically confirmed IDC. The final data such as tumor size, SLN and non-SLN status were obtained by further analysis of pathohistological reports from tumor biopsy and other surgical specimens. The accuracy rate of SLN detection was 98%. The number of detected SLN was in the range of 1 to 6, with an average of 2 for each patient. The number of positive SLN was in significant correlation with the number of tumor-affected non-SNL (p<0,001). Further analysis showed that for each increase in the number of positive SLN by 1, the risk of positive non-SLN increased 6-fold, OR=6,22 (p<0,001). Use of methylene blue dye as a sole mapping agent when performing SLNB in patients with IDC is a reliable and effective method that can be safely implemented in medical institutions that lack availability of nuclear medicine services or significant monetary funds.
Sections du résumé
BACKGROUND
BACKGROUND
Invasive ductal cancer (IDC) represents about 75% of all breast malignancies. There are many breast cancer prognostic factors, but the ones that have the most impact on the survival rates in advanced breast cancer are tumor size and regional lymph node involvement. Axillary lymph node dissection (ALND) has particularly important and undoubtful role in current surgical options for breast cancer treatment. With the introduction of sentinel lymph node biopsy (SLNB) for breast cancer patients it was possible to identify those to whom regional spread of the disease did not occur at the time of surgery, and thus spare them an unnecessary ALND procedure.
OBJECTIVE
OBJECTIVE
To determine the rate of sentinel lymph node (SLN) detection using only methylene blue dye as a mapping agent, as well as to correlate the number of positive SLNs with the number of positive non-sentinel lymph nodes (non-SLNs).
METHODS
METHODS
The study represents a prospective study that included 50 female patients with histologically confirmed invasive ductal carcinoma (IDC) who underwent SLNB using only methylene blue dye as the mapping agent, while the detection and harvest of SNL was done by visual control only. All patients also underwent an obligatory complete ALND, which was as that time the institutional oncological protocol for surgical treatment of histologically confirmed IDC. The final data such as tumor size, SLN and non-SLN status were obtained by further analysis of pathohistological reports from tumor biopsy and other surgical specimens.
RESULTS
RESULTS
The accuracy rate of SLN detection was 98%. The number of detected SLN was in the range of 1 to 6, with an average of 2 for each patient. The number of positive SLN was in significant correlation with the number of tumor-affected non-SNL (p<0,001). Further analysis showed that for each increase in the number of positive SLN by 1, the risk of positive non-SLN increased 6-fold, OR=6,22 (p<0,001).
CONCLUSION
CONCLUSIONS
Use of methylene blue dye as a sole mapping agent when performing SLNB in patients with IDC is a reliable and effective method that can be safely implemented in medical institutions that lack availability of nuclear medicine services or significant monetary funds.
Identifiants
pubmed: 35210951
doi: 10.5455/msm.2021.33.282-287
pii: MSM-33-282
pmc: PMC8812375
doi:
Types de publication
Journal Article
Langues
eng
Pagination
282-287Informations de copyright
© 2021 Emir Halilbasic, Ermina Iljazovic, Zlatan Mehmedovic, Eldar Brkic, Goran Sarkanovic.
Déclaration de conflit d'intérêts
There are no conflicts of interest.
Références
Turk Patoloji Derg. 2011;27(3):189-95
pubmed: 21935867
Cancer. 1989 Jan 1;63(1):181-7
pubmed: 2910416
Anticancer Res. 2009 Oct;29(10):4119-25
pubmed: 19846959
J Natl Cancer Inst. 2006 May 3;98(9):599-609
pubmed: 16670385
J Natl Cancer Inst. 2010 Feb 3;102(3):170-8
pubmed: 20071685
BMC Cancer. 2008 Mar 04;8:66
pubmed: 18315887
Arch Surg. 1999 Feb;134(2):195-9
pubmed: 10025463
Cancer. 2004 Feb 15;100(4):715-22
pubmed: 14770426
Arch Surg. 2004 Jun;139(6):634-9; discussion 639-40
pubmed: 15197090
Cancer. 2000 Feb 1;88(3):608-14
pubmed: 10649254
Ann Surg. 2001 May;233(5):676-87
pubmed: 11360892
Surgery. 1999 Oct;126(4):714-20; discussion 720-2
pubmed: 10520920
Ann Surg. 1997 Sep;226(3):271-6; discussion 276-8
pubmed: 9339933
J Am Coll Surg. 2001 Nov;193(5):473-8
pubmed: 11708502
J Clin Oncol. 2000 Jul;18(13):2560-6
pubmed: 10893287
N Engl J Med. 1985 Mar 14;312(11):674-81
pubmed: 3883168
Eur J Surg Oncol. 2007 Mar;33(2):147-52
pubmed: 17081723
Cancer. 2000 Aug 1;89(3):574-81
pubmed: 10931456
Adv Surg. 1999;32:349-64
pubmed: 9891752
Ann Surg Oncol. 2009 Dec;16(12):3366-74
pubmed: 19760047
Int J Radiat Oncol Biol Phys. 2009 Nov 15;75(4):1035-40
pubmed: 19327916
J Clin Oncol. 1999 Jun;17(6):1720-6
pubmed: 10561208
Cancer Treat Res. 1996;86:183-9
pubmed: 8886446