ThP2.3 - Fluorescein Sodium - An Alternative to Methylene Blue In Detecting Sentinel Axillary Lymph Node In Carcinoma Breast

Abstract

Abstract Aim To ascertain the validity of fluorescein sodium in the identification of SLN in patients with Breast carcinoma. Material and Methods A Prospective Observational study was conducted among 30 patients with carcinoma breast aged >18 years with no clinically identifiable axillary lymph nodes at the Department of General Surgery at a single centre, in rural India over period of 2 year. Institutional Ethical clearance was obtained prior to the start of the study and Informed consent was obtained from all the patients recruited Results Mean age was 53.13 ± 14.180 years. The majority of subjects were in the age group 51 to 60 years (26.7%). 20% were in stage T2N0M0, 30% were in T3N0M0 and 50% were in T4BN0M0. on HPE 86.7% had Infiltrating Ductal Ca, 10% had Lobular Ca and 3.3% had Squamous Cell Ca. Fluorescein Dye staining had a sensitivity of 84.21%, specificity was 30.99%, Positive Predictive Value was 39.51%, Negative Predictive Value was 78.57% and Diagnostic Accuracy was 49.54% in comparison with HPE. Methylene Blue staining had a sensitivity of 44.74%, specificity was 35.21%, Positive Predictive Value was 26.98%, Negative Predictive Value was 54.35% and Diagnostic Accuracy was 38.53% in comparison with HPE. Conclusion From the study findings it can be concluded that the detection of SLNs using fluorescein was high compared to methylene blue, both methods were feasible and safe in patients with breast carcinoma. Fluorescein dye had better validity in the diagnosis of Sentinel lymph node compared to Methylene blue in the Carcinoma of the breast.