Abstract 2705: In search of a cost effective sentinel node biopsy technique: A randomized trial comparing the use of methylene blue and patent blue violet to identify sentinel node in breast cancer

Abstract

Abstract One of the most significant breakthroughs in breast cancer management in recent times has been in the area of sentinel lymph node biopsy (SLNB), which is now an established staging technique for assessing regional lymph node status while minimizing the morbidity associated with conventional axillary lymph node dissection. Recommended technique of SLNBis the combination of blue dye (isosulfan blue or patent blue violet) and radiotracer. However, neither of the blue dyes are currently marketed in India & are expensive. Thus, SLNB technique as practiced in the West is unlikely to be used widely in economically less developed nations. In India, some surgeons use methylene blue (MB) for identification of sentinel node in breast cancer with variable success rates. However, there are no large randomized trials comparing the efficacy of MB vis a vis isosulfan blue or patent blue violet (PBV) in identifying sentinel node in literature Objective To compare the sentinel node (SN) identification rate using patent blue violet (PBV) and methylene blue (MB) in combination with radiotracer in breast cancer. Sample size Assuming that MB identified SN in 60% cases and PBV in 85% of cases, a two group continuity corrected X2 test with 0.05 two sided test will have 80% power to detect the difference when the sample size is 57. Inclusion criteria Clinically axillary lymph node negative (N0) patients with breast cancer with tumor (T) stage T1, T2, Tx. willing to participate TechniqueCombination technique. Sentinel node: Any LN that is blue/ hot/ hot and blue is defined as SN. Any lymph node to which a blue stained lymphatic leads/ends will also be considered as SN. Results Study Period: Feb 2010-Nov 2011 No of Pts: 102 Age range: 31-82 yrs (mean: 41.4 yrs) Menopausal Status: Pre: 46 Post: 56 Side: R:L:: 50:52 T status: T1: 34; T2: 64; Tx SN identification rates: PBV: 46/49 MB: 51/53 (p value: NS) Conclusions Sentinel node can be identified with equal success rates using MB & PBV. Methylene blue can be used as a cost effective sentinel node biopsy technique in breast cancer in economically less developed countries Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2705. doi:1538-7445.AM2012-2705