Detection of the Sentinel Lymph Node in Breast Cancer Using Patent Blue Dye Technique, Gamma Probe and Combined Technique

Abstract

Abstract Background Breast cancer is the most common cancer among women and the second-leading cause of cancer deaths, Lymphatic mapping with SLN dissection provides a reliable image of the tumor status of the remaining axillary lymph nodes and it has the benefit of reducing the morbidity associated with the axillary lymph node dissection, including pain, sensory deficits, decreased range of movement, seromas and lymphedema, There is several techniques to determine SLN, in this study we used patent blue dye and gamma probe techniques in the detection of the sentinel lymph node. Objective To estimate and compare the detection rate of the sentinel lymph node in clinically and radiologically negative axillary node in breast cancer female patients by using of patent blue technique, gamma probe technique and a combination technique. Patients and Methods This study is prospective study included 90 female Egyptian women with early breast cancer and clinically negative axilla clinically and radiologically. These women divided into 3 groups according to the technique used in the detection of SLNB (first group used patent blue only, 2nd group used gamma probe only, 3rd group used combined techniques (patent blue and gamma probe). Results The most frequent site of lesion in the three groups was the upper outer quadrant; 80% in group I, 76.7% in group II, and 83.3% in group III. The most frequent pathology in the study groups was infiltrating duct carcinoma; 96.7% in all groups. No significant differences were observed between the study groups regarding neuropathic pain (P-value = 0.319). Patients with positive SLN in Group I 16.7%, in group 2 23.3% and in group 3 33.3%. No significant differences were observed between the study groups regarding number of SLN removed (P-value = 0.233), patients with positive SLN (P-value = 0.319) and number of patients underwent axillary clearance (P-value = 0.319). Conclusion This study confirms that prediction of axillary lymph node status in breast cancer patients using combined technique has the same accuracy as marking of SN with blue dye alone and therefore should be preferred.