Efficacy of the Management of Node Negative Early Stage Breast Cancer Using 1% Methylene Blue in Sentinel Lymph Node Biopsy:prospective study, kasrAlaini University Hospital

Abstract

Background:Accurate staging and proper management of axillary lymph nodes are important for the treatment of breast cancer. Sentinel lymph node biopsy (SLNB) provides accurate assessment of nodal status.Aimof work:Evaluation the safety, the accuracy and the cost of the application of SLNB using methylene blue 1% (MB 1%) in cases of node negative early stage breast cancer.Patients and methods:This study was conducted at Kasr Al-Ainy university Hospitals, Faculty of Medicine, Cairo University. Fifty-two female patients with node negative early stage breast cancer who agreed on undergoing breast conservative surgery( BCS), SLNB using 1% methylene blue and frozen section examination then managed according to ACOSOG Z0011 criteria .Results:Identification in 50 surgical specimens (identification rate 96.15%). By evaluating frozen section examination of the lymph nodes in relation to paraffin section examination we found that the sensitivity of the frozen section examination was 100% and specificity was 97.5% with positive predictive value 90.9%, negative predictive value 100% and overall accuracy was 98%.Conclusion:One % MB dye is very effective as a single agent in SLNB in node negative early stage breast cancer with very high identification rate compared to patent blue and radiocolloids. Implementation of ACOSOG Z0011 criteria proved its validity throughout our study as average 12 months follow up showed no locoregional recurrence