The predictive value of methylene blue dye as a single technique in breast cancer sentinel node biopsy: a study from Dharmais Cancer Hospital

World Journal of Surgical Oncology

Research

Rizky Ifandriani Putri¹  Lenny Sari¹  Walta Gautama²  Bob Andinata²  Ramadhan Karsono³  Samuel J. Haryono³  Bayu Brahma⁴ 

[1] Department of Anatomical Pathology, Dharmais Cancer Hospital, 11420, Jalan. Let. Jend. S. Parman Kav. 84-86, Jakarta, Indonesia;Department of Surgical Oncology, Dharmais Cancer Hospital, Jalan. Let. Jend. S. Parman Kav. 84-86, 11420, Jakarta, Indonesia;Department of Surgical Oncology, Dharmais Cancer Hospital, Jalan. Let. Jend. S. Parman Kav. 84-86, 11420, Jakarta, Indonesia;Departement of Surgical Oncology, Mochtar Riady Comprehensive Cancer Center (MRCCC) Siloam Hospital, Jalan Garnisun Dalam No. 2-3, Semanggi, 12930, Central Jakarta, Indonesia;Department of Surgical Oncology, Dharmais Cancer Hospital, Jalan. Let. Jend. S. Parman Kav. 84-86, 11420, Jakarta, Indonesia;Department of Surgical Oncology, Bogor City General Hospital, Jalan DR. Semeru No. 120, 16112, West Bogor, West Java, Indonesia;

关键词: Sentinel node;    Breast cancer;    Axillary lymph node;    Methylene blue dye;   

DOI  :  10.1186/s12957-017-1113-8

 received in 2016-08-19, accepted in 2017-02-01,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundAxillary lymph node dissection (ALND) has been the standard treatment of breast cancer axillary staging in Indonesia. The limited facilities of radioisotope tracer and isosulfan or patent blue dye (PBD) have been the major obstacles to perform sentinel node biopsy (SNB) in our country. We studied the application of 1% methylene blue dye (MBD) alone for SNB to overcome the problem.MethodsThis prospective study enrolled 108 patients with suspicious malignant lesions or breast cancer stages I–III. SNB was performed using 2–5 cc of 1% MBD and proceeded with ALND. The histopathology results of sentinel nodes (SNs) were compared with axillary lymph nodes (ALNs) for diagnostic value assessments.ResultsThere were 96 patients with invasive carcinoma from July 2012 to September 2014 who were included in the final analysis. The median age was 50 (25–69) years, and the median pathological tumor size was 3 cm (1–10). Identification rate of SNs was 91.7%, and the median number of the identified SNs was 2 (1–8). Sentinel node metastasis was found in 53.4% cases and 89.4% of them were macrometastases. The negative predictive value (NPV) of SNs to predict axillary metastasis was 90% (95% CI, 81–99%). There were no anaphylactic reactions, but we found 2 cases with skin necrosis.ConclusionsThe application of 1% MBD as a single technique in breast cancer SNB has favorable identification rates and predictive values. It can be used for axillary staging, but nevertheless the technique should be applied with attention to the tumor size and grade to avoid false negative results.

【 授权许可】

CC BY   
© The Author(s). 2017