Methylene blue guided sentinel lymph node biopsy in 276 breast cancer patients
摘要
Objective To evaluate the feasibility of methylene blue as a method in lymphatic mapping and the effect factors of SLNB identification rate. Methods The results of SLNB in 276 patients with clinical stage T -T2N0M0 breast eaneer were analyzed to evaluate the effect factors of identification rate and false-neg-ative rate of SLNB. Results The identification of SLN was carried out using methylene blne . When the mapping time of SLN and lymphatic were controlled in 20～30 minutes, the SLN could be visualized easily. SLN was successfully identified in 246 of 276 patients (89.1%) ,423 SLNs were retrieved(1～4). The SLN accurately predicted the status of the axilla in 226 of 246 patients (77.3%) yielding a FNR(false negative rate)of 8.1% (20/246) ,false positive rate of0, and an accuracy of 91.9% (226/241). For the identified rate of SLN, the clinical stage of T2N0M0 disease was higher than the clinical stage of T1N0M0 disease (P=0.046,P<0.05), Upper outer quadrant and lower outer quadrant were higher than other evidently (P<0.0010). SLNs were easily retrieved in those cases aged above 50 years than below 50 years (P<0.001).In the view of false-negative rate of SLNB, the FNR rate in patients of 50 years old was less than older ones (P=0.037, P<0.05). No significant correlation was found between the stage of TMN, the expression of ER and PR, histologic status and FNR. Conclusion When SLNB was performed using methylene blue, we found age, clinical stage of TMN, the location of tumor had relationship with the identified rate of SLN. Ag-ing and location of tumor may adversely affect FNR of SLNB. Key words: breast cancer; methylene blue; sentinel lymph node; excisioual biopsy