Validation sentinel lymph node biopsy study in cN0 axilla using low-cost dual dye technique: potential solution for resource poor settings

Chavda, Jayesh; Mishra, Arpan; Silodia, Ashutosh; Yadav, Sanjay Kumar; Sharma, Deepti Bala; Sharma, Dhananjaya; Khandare, Muktesh

doi:10.1007/s10549-022-06556-w

Cited by 9 publications

(7 citation statements)

References 25 publications

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“…Secondary factors such as cost, and turnaround time also favor the use of TIC [40]. If TIC can be combined with low‐cost SLNB techniques [41, 42] then it can address the issue of low rates of SLNB in LMICs in a cost‐effective way while sparing the patients the trauma of psychological and physical stress of a second surgery.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review and Meta‐analysis of Touch Imprint Cytology and Frozen Section Biopsy and Their Comparison for Evaluation of Sentinel Lymph Node in Breast Cancer

Bharath

Sharma²,

Yadav³

et al. 2022

World j. surg.

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Introduction Evaluation of axillary lymph nodes after sentinel lymph node biopsy (SLNB) in breast cancer is mostly done by intra-operative frozen section biopsy (FSB) and/ or touch imprint cytology (TIC). In this systematic review and meta-analysis, we have compared the accuracy of the two modalities. Methods PubMed, EMBASE, and Cochrane electronic databases were searched for articles comparing TIC with FSB. Articles were assessed for methodological and reporting quality. The main summary measures were pooled sensitivity, pooled specificity, and diagnostic accuracy using bivariate generalized linear mixed models using random effects. Results Fourteen studies were included. The pooled sensitivity, specificity, and diagnostic accuracy for FSB were 78%, 100%, and 98.57%. For TIC, the pooled sensitivity, specificity, and diagnostic accuracy were 74%, 98%, and 98.37%. For both methods, visual inspection of summary ROC curves and of forest plots did not show significant heterogeneity. Conclusion TIC showed comparable sensitivity, specificity, and accuracy to FSB and hence can be used as its substitute as a rapid and economical test for the detection of axillary lymph node metastasis during SLNB especially in low-resource settings.

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Section: Discussionmentioning

confidence: 99%

A Systematic Review and Meta‐analysis of Touch Imprint Cytology and Frozen Section Biopsy and Their Comparison for Evaluation of Sentinel Lymph Node in Breast Cancer

Bharath

Sharma²,

Yadav³

et al. 2022

World j. surg.

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“…These include low-cost core needle biopsy technique, low-cost SLNB technique and clinical breast examination etc. [18][19][20] These validated low-cost alternatives deserve to be included in various guidelines and National Cancer Control Plan (NCCP) of each country.…”

Section: Discussionmentioning

confidence: 99%

Barriers and challenges in providing standard breast cancer care in low resource settings

et al. 2022

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In this study, we investigated the barriers to the delivery of internationally accepted breast cancer care in low resource settings (LRS) as compared to well-endowed resource settings (WRS) via an online survey. The survey was completed by 199 surgeons from eleven countries: 51 from WRS and 148 from LRS, based on our definition. The two most common facilities lacking in LRS were sentinel lymph node biopsy and immune-histochemistry (67% and 60% respectively). Only 22% respondents from LRS confirmed that all their eligible patients received hormonal therapy and only 8% radiotherapy as compared to 98% and 75% from WRS. Widespread limitations exist in most LRS, making internationally accepted breast cancer treatment guidelines impossible to follow, and thus resulting in suboptimal cancer care.

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“…Our previously validated technique of low-cost dual dye SLNB under local anaesthesia enabled us to perform SLNB in our EBC patients. 6 These drawbacks were overcome by performing the SLNB under local anaesthesia as the first stage and then performing the definitive BCS ± ALND or SM ± ALND under general anaesthesia in the second stage once the histopathology report became available after a few days. Touch imprint cytology for SLNB specimens may be a substitute and we are currently conducting a prospective study to evaluate its accuracy.…”

Section: Discussionmentioning

confidence: 99%

“…5 All patients were subjected to sentinel lymph node biopsy (SLNB) using a low-cost dual dye technique under local anesthesia at first-stage surgery. 6 After receiving the histopathological report, a second-stage surgery was planned; patients were offered the choice between breast conservation surgery (BCS) and simple mastectomy with or without axillary lymph node dissection (ALND) depending upon the SLNB status. Those opting for BCS underwent oncoplastic breast surgery (OPBS) with a macroscopic margin of at least 1 cm.…”

Section: Methodsmentioning

confidence: 99%

Low-cost solutions incorporated in a standard surgical pathway for early breast cancer: A pilot study

Yadav

Sharma

et al. 2022

Trop Doct

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We present the results of incorporation of low-cost solutions to provide a standard surgical care for early breast cancer (EBC) patients. This surgical pathway consists of a low-cost vacuum-assisted core needle biopsy, sentinel lymph node biopsy (SLNB) using low-cost methylene blue and fluorescin dyes under local anesthesia and oncoplastic breast surgery. Patients assessed as clinically node-negative axilla underwent such treatment. SLNB using low-cost dyes was performed without any complication. Oncoplastic surgical techniques were opted for in 32 patients, and the lumps were all excised with a ∼1-cm all-around margin on the final histopathological examination. Standard breast cancer surgery can be provided in low-resource settings to eligible EBC patients with low-cost solutions.

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Validation sentinel lymph node biopsy study in cN0 axilla using low-cost dual dye technique: potential solution for resource poor settings

Cited by 9 publications

References 25 publications

A Systematic Review and Meta‐analysis of Touch Imprint Cytology and Frozen Section Biopsy and Their Comparison for Evaluation of Sentinel Lymph Node in Breast Cancer

A Systematic Review and Meta‐analysis of Touch Imprint Cytology and Frozen Section Biopsy and Their Comparison for Evaluation of Sentinel Lymph Node in Breast Cancer

Barriers and challenges in providing standard breast cancer care in low resource settings

Low-cost solutions incorporated in a standard surgical pathway for early breast cancer: A pilot study

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