Background: Modern screening methods has made it possible to diagnose breast cancer in as early stage as possible and axillary lymph node status is still the most important prognostic indicator in carcinoma breast. In this study we are trying to analyse the preference of lymph nodal staining in SLNB using methylene blue in early breast cancer, so that surgeons will be more aware of anatomical positions of the stained nodes, thus favouring more precise dissection, reducing the morbidity.Methods: This was a prospective observational study conducted in the Department of General Surgery, Government Medical College, Kottayam. All cases of clinically N0 carcinoma breast undergoing modified radical mastectomy were included. We injected 3 ml of methylene blue in the subareolar region in three places depending on the quadrant in which tumour was situated, before putting the skin incision for modified radical mastectomy and the pathologist segregated the stained lymph nodes after confirming the anatomical locations.Results: The study here was diagnostic test evaluation and the diagnostic test being evaluated was sentinel lymph node biopsy using methylene blue. Commonest group of lymph nodes, where sentinel lymph nodes were identified were anterior group (30 out of 34 sentinel lymph nodes).Conclusions: Though sentinel lymph node biopsy using methylene blue is not a fool proof method; knowing the mode of methylene blue flow i.e., anterior more than central and then posterior group of lymph nodes will definitely reduce the morbidity involved, and above all saving time of the surgery.

Background: Spindle cell lesions of breast comprise a rare group of complex entities which may be reactive, benign or malignant. Though definitive diagnosis is difficult especially in small biopsies, it is of utmost importance since the management differs. Precise knowledge of the lesions in this group, thorough sampling, clinic radiological correlation and ancillary techniques will aid in making the correct diagnosis. Review of literature showed only a few extensive studies on spindle cell lesions in breast, especially from South India.Methods: Our research is a descriptive histopathological analysis of 55 cases of spindle cell lesions of breast, done over a 2-year period from Jan 2015 to Dec 2016 in the Pathology department, of our institution.Results: A total of 55 cases were received. The reactive spindle cell proliferations were Diabetic mastopathy, Pseudoangiomatous stromal hyperplasia, and sclerosing adenosis. Benign phyllodes tumour, spindle cell lipoma and neurofibroma comprised the benign category. The malignant lesions included metaplastic carcinoma, malignant phyllodes tumour and sarcoma.Conclusions: Benign lesions constituted the majority (60%) in our study. Of these, benign phyllodes tumour constituted the majority, 41.8% of the total cases. The remaining 40% were malignant spindle cell neoplasms, of which metaplastic carcinoma was the single largest group accounting for 29.1%. Since reactive and benign spindle cell lesions may show atypia, definitive diagnosis should be made only after considering atypical mitotic figures, presence of necrosis and imaging findings. A wide excision with adequate margins is necessary in incision biopsies with suspicious findings.