Abstract
BackgroundIn early breast cancer, the optimal technique for sentinel lymph node biopsy (SLNB) is the combined technique (radioisotope and Patent Blue V) which achieves high identification rates. Despite this, many centres have decided to stop using blue dye due to blue-dye-related complications (tattoo, anaphylaxis). We evaluated the SLNB identification rate using the combined technique with and without Patent Blue V and the blue-dye-related complication rates.MethodsClinical and histological data were analysed on patients undergoing SLNB between March 2014 and April 2015. SLNB was performed following standard hospital protocols using the combined technique.ResultsA total of 208 patients underwent SLNB and 160 patients (342 nodes) with complete operation notes were available for final analysis. The identification rate with the combined technique was 98.8% (n = 158/160), with blue dye alone 92.5% (n = 148/160) and with radioisotope alone 97.5% (n = 156/160). A total of 76.9% (263/342) of nodes were radioactive and blue, 15.5% (53/342) only radioactive and 2.3% (8/342) only blue, 5.3% (18/342) were neither radioactive nor blue. No anaphylactic reactions were reported and blue skin staining was reported in six (3.8%) patients.ConclusionThe combined technique should continue be the preferred technique for SLNB and should be standardised. Radioisotope alone (but not blue dye alone) has comparable sentinel node identification rates in experienced hands. National guidelines are required to optimise operative documentation.
Highlights
In early breast cancer, sentinel lymph node biopsy (SLNB) is the preferred method for axillary staging [1,2]
It is well known that use of the combination of radioisotope and blue dye is significantly better than the two tracers in isolation [7,8,9]
We evaluated the SLNB identification rate in experienced hands using the combined technique with and without Patent Blue V and the blue-dye-related complication rates
Summary
Sentinel lymph node biopsy (SLNB) is the preferred method for axillary staging [1,2]. We evaluated the SLNB identification rate in experienced hands using the combined technique with and without Patent Blue V and the blue-dye-related complication rates. The optimal technique for sentinel lymph node biopsy (SLNB) is the combined technique (radioisotope and Patent Blue V) which achieves high identification rates. We evaluated the SLNB identification rate using the combined technique with and without Patent Blue V and the blue-dye-related complication rates. The identification rate with the combined technique was 98.8% (n = 158/160), with blue dye alone 92.5% (n = 148/160) and with radioisotope alone 97.5% (n = 156/160). Radioisotope alone (but not blue dye alone) has comparable sentinel node identification rates in experienced hands.
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