Clinical study on sentinel lymph node in breast cancer patients through injection of methylene blue

Abstract

Objective To identify the sentinel lymph node in breast cancer patients by injection of methylene blue andanalyse the relations between the sentinel lymph node(SLN)and axillary lymph node(ALN).Method 45 breast cancer patients were injected with methylene blue to find SLN during operation.The SLN dyed by methylene blue and Cancer specimens were removed and submitted to pathological examination at the same time.All patients suffering from breast cancer showed by pathological examination were treated by the traditional radical or modified radical mastectomy.The sensitivity in prediction of ALN metastasis by SLN biopsy was showed through postoperative pathological analysis and would provide data for the development in operation of breast cancer.Results In 45 cases,SLN dyed by methylene blue was identified in 36.Malignant turnout invasion was revealed in 21 of 36 cases,and cancer metastasis was also observed by postoperative axillary lymph node pathology in the 21 patients.13 of 36 cases showed no cancer invasion and ALN metastasis by pathological examination.2 of 36 patients who showed uninvaded SLN were demonstrated to have ALN metastasis.Therefore,the prediction of ALN metastasis by SLN biopsy showed a sensitivity of 94.5%(34/36)and a false negative rate of 5.5%(2/36).SLN was not identified at the time of operation in 9 patients,and postoperative axillary lymph node pathology also showed no cancer metastasis in all of them.Conclusion SLN in breast cancer patients can be identified by injection of methylene blue,and the sensitivity in prediction of ALN metastasis by SLN biopsy is 94.5%.If the 9 patients in whom SLN are not identified are regarded as the corresponding cases,the sensitivity may be up to 95.6%(43/45).The false negative rate of the study is 4.4%(2/45). Key words: Breast neoplasms; Lymphatic metastasis; Biopsy; Methylene blue