Diagnostic accuracy of sentinel lymph node biopsy in predicting the axillary lymph node status in operable breast cancer

Dr. Vijaypal Singh; Dr. Neel Shah; Dr. Bhairu Lal Gurjar; Dr. Dharampal Godara; Dr. Pinakin Patel; Dr. Suresh Singh; Dr. Raj Govind Sharma; Dr. Vineet Sharma

Volume : V, Issue : VI, June - 2016

Diagnostic accuracy of sentinel lymph node biopsy in predicting the axillary lymph node status in operable breast cancer

Dr. Vijaypal Singh, Dr. Neel Shah, Dr. Bhairu Lal Gurjar, Dr. Dharampal Godara, Dr. Pinakin Patel, Dr. Suresh Singh, Dr. Raj Govind Sharma, Dr. Vineet Sharma

Abstract :

 Introduction: Carcinoma of east is the commonest malignancy found in females, worldwide. The management of operable carcinoma east is modified radical mastectomy (MRM) or east conservative therapy (BCT). However, axillary lymph node dissection (ALND) is accompanied by numerous complications. Hence, if we can somehow determine the axilla to be free from metastatic disease, a significant morbidity can be avoided by omitting ALND. This study was performed to determine whether sentinel lymph node is a predictor of axillary lymph node status in operable east cancer. Methods and materials: A total of 70 patients operated for operable east cancer between June 2014 and December 2015 were included in the study. A sentinel lymph node biopsy was performed using methylene blue dye. Surgery for the primary tumour was done along with ALND. The results of the histopathology examination of the two specimens were compared. Results: In this study the use of methylene blue dye was found to accurately identify sentinel node in 91.43% cases with a sensitivity of 72.7% and specificity of 100%. The overall accuracy of sentinel lymph node biopsy found in this study was 90.6% which revealed that their status accurately predicts the status of the axillary nodes. However, it has a high false negative rate of 27.3%. Conclusion: Methylene blue was found to be a cheaper and safer alternative for the sentinel lymph node biopsy. This procedure can be used with confidence in surgical practice after achieving the short learning curve in operable east cancer. But a high false negative rate calls for caution in patients with negative sentinel nodes