Sentinel lymph node biopsy in breast cancer by using isosulfan blue

ABSTRACT

To determine the sensitivity of sentinel node involvement by breast cancer in case of clinically axillary lymph node negative breast cancer. The study was conducted at Pakistan Institute of Medical Sciences, Islamabad in department of general surgery ward 5 from March 2006 to July 2007. Thirty patients with tumor size of either T1 or T2 and clinically negative axillary lymph node were enrolled in this study. These patients were subjected to sentinel lymph node biopsy by blue dye injected in peri-tumor parenchyma then dissection was done to localize sentinel node followed by formal axillary dissection [level II]. The histopathology of sentinel node was compared with axillary lymph node. Sentinel lymph node was successfully localized in all 30 patients [100%]. The sensitivity, specificity, accuracy and false negative rate were 92.8%, 100%, 96.7%, 5.9% respectively. The axilla was metastatic in 14 cases [46.7%], one had negative sentinel lymph node but positive non sentinel lymph node [false negative], and four had sentinel lymph node metastasis alone. Sentinel lymph node biopsy by using blue dye have a high diagnostic accuracy and prevent unnecessary dissection of axilla in majority of patients with early node negative breast carcinoma