Sentinel lymph node biopsy using methylene blue dye and intraoperative palpation method in node-negative early breast cancer

Abstract

Background: Early breast cancer with clinical or radiological node-negative axilla is treated with breast conservation surgery where lumpectomy with axillary dissection is done. Sentinel lymph node biopsy (SLNB) is an acceptable alternative to axillary clearance and has relatively lesser morbidity. SLNB methods include radioisotope (RI)-guided, blue dye-guided, or a combination of both. However, access to RI can be limited in certain geographic locations. Objective: This study aimed to determine the effectivity of methylene blue (MB) dye-guided SLNB as an alternative to RI. Methods: In this investigation, 43 clinically nodenegative early breast cancer patients were prospectively enrolled. SLNB was performed using MB dye (1%) administered to the peritumoral or periareolar region. The histopathology reports of the harvested nodes were studied, and the results were computed using SPSS and 2×2 contingency table. Results: The sensitivity, specificity, false-negative rate (FNR), and accuracy of MB-guided SLNB in our study were 92.8%, 100%, 7.14%, and 97.7%, respectively. Conclusion: The use of MB dye along with intraoperative palpation after meticulous lymph node dissection in each level is more effective and has lower FNR than RI.