K. Tatsuda1, M. Nagahashi1, J. Tsuchida1, K. Moro1, T. Niwano1, C. Toshikawa1, M. Hasegawa1, Y. Koyama1, T. Kobayashi1, S. Kosugi2, H. Kameyama1, T. Wakai1 1Niigata University Graduate School Of Medical And Dental Sciences,Division Of Digestive And General Surgery,Niigata, NIIGATA, Japan 2Uonuma Kikan Hospital,Digestive And General Surgery,Minami-Uonuma City, NIIGATA, Japan
Introduction:
Blue dyes and radioisotope tracers have been used, either alone or in combination, to identify the sentinel lymph node (SLN). Previous studies indicate a superiority of combination of dye and isotope for SLN biopsy in breast cancer patients to a single method of blue dye in terms of lower non-identification and false-negative rates. With increasing experience, however, surgeons had become comfortable to use the single method of dye. The use of blue dye alone remains an attractive option because of its technical simplicity and because it does not require any additional equipment or procedures. In this study, we re-evaluate the practice of performing sentinel lymph node biopsy with blue die alone.
Methods:
A retrospective analysis was conducted of 114 consecutive patients with breast cancer at the authors’ institute between January 2014 and March 2015, when SLN biopsy was offered to all suitable patients with either a method with combined dye and isotope or dye alone. All procedures were done by experienced surgeons for SLN biopsy.
Results:
During the study period, 66 patients underwent SLN biopsy with combined dye and isotope, and 48 patients underwent that with dye alone. The SLN was identified in all patients in each group. There was no difference between SLN biopsy with combined dye and isotope and that with dye alone in terms of operation time, time for SLN procedure, and number of SLN (median; n = 2). A positive rate for SLN metastasis was 19.6% (13/66) for patients underwent SLN biopsy with combined dye and isotope, and 12.5% (6/48) 48 patients underwent that with dye alone; there was no difference between the groups (P = 0.446).
Conclusion:
Our results indicate that SLN with dye alone is feasible for patients with breast cancer with comparable outcome to the combined method. SLN with dye alone remains an option for experienced surgeons because of its technical simplicity and because it does not require any additional equipment or procedures.
This work was supported by the Japan Society for the Promotion of Science (JSPS) Grant-in-Aid for Scientific Research Grant Number 15H05676 and 15K15471 for M.N and 15H04927 for W.T. M.N. is supported by the Uehara Memorial Foundation, Nakayama Cancer Research Institute, Takeda Science Foundation, and Tsukada Memorial Foundation.