Comparison of the accuracy of isosulfan blue and technetium-99m lymphoscintigraphy to determine axillary lymph node metastasis in breast cancer

ABSTRACT

This study aimed to compare the efficiency of isosulfan blue [ISB] and colloid methods in determining metastatic conditions of axillary lymph node in sentinel lymph node biopsy [SLNB]. This prospective study was performed between April 2005 and July 2009 at Gulhane Medical Faculty, Department of General Surgery. A total of 102 female patients diagnosed with breast cancer were enrolled in the clinic of Gulhane School of Medicine. According to the diagnostic protocols of SLN, the patients were divided into three groups as follows ISB [group I], colloid [group II], and ISB and colloid [group III]. SLN was identified in 49 of 52 patients [94.2%] in the ISB group; the sensitivity, specificity, negative predictive value [NPV], positive predictive value [PPV], and false negativity [FN] ratio were found to be 90.9%, 75.8%, 96.1%, 55.5%, and 9.1%, respectively. On the contrary, the sentinel lymph node was identified in 38 of 38 [100%] patients in the colloid group; the sensitivity, specificity, PPV, NPV, and FN were found to be 88.2%, 100%, 100%, 91.3%, and 11.8%, respectively. In ISB and colloid groups; SLN was identified in 12 of 12 [100%] patients in the ISB and colloid groups; the sensitivity, specificity, PPV, NPV, and FN were found to be 100%, 100%, 100%, and 0%, respectively. This study showed that the combined methods applied to heterogeneous groups of patients for SLNB in breast cancer cases were minimally invasive and effective and hence could be used for evaluating nodal metastases