Ramin Sadeghi1, Ghazaleh Alesheikh2, Seyed Rasoul Zakavi2, Asiehsadat Fattahi3, Abbas Abdollahi3, Mehdi Assadi4, Ali Jangjoo4, Mohammed Keshtgar5. 1. Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address: sadeghir@mums.ac.ir. 2. Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 3. Minimally Invasive and Endoscopic Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 4. Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. 5. Consultant Surgical Oncologist, Royal Free Hospital and University College, London, UK.
Abstract
BACKGROUND: In the current study, we evaluated the incremental value of blue dye injection in sentinel node mapping of early breast cancer patients. We specially considered the experience of the surgeons and lymphoscintigraphy results in this regard. METHODS: 605 patients with early stage breast cancer were retrospectively evaluated in the study. Patients underwent sentinel node mapping using combined radiotracer and blue dye techniques. Lymphoscintiraphy was also performed for 590 patients. Blue dye, radioisotope, and overall success rates in identifying the sentinel lymph node were evaluated in different patient groups. The benefit of blue dye and radioisotope in identifying the sentinel lymph nodes was also evaluated. RESULTS: Marginal benefits of both blue dye and isotope for overall sentinel node detection as well as pathologically involved sentinel nodes were statistically higher in inexperienced surgeons and in patients with sentinel node visualization failure. In the patients with sentinel node visualization on lymphoscintigraphy, 6 sentinel nodes were detected by blue dye only. All these six nodes were harvested by inexperienced surgeons. On the other hand 8 sentinel nodes were detected by dye only in the patients with sentinel node non-visualization. All these nodes were harvested by experienced surgeons. CONCLUSIONS: The use of blue dye should be reserved for inexperienced surgeons during their learning phase and for those patients in whom lymphoscintigraphy failed to show any uptake in the axilla.
BACKGROUND: In the current study, we evaluated the incremental value of blue dye injection in sentinel node mapping of early breast cancerpatients. We specially considered the experience of the surgeons and lymphoscintigraphy results in this regard. METHODS: 605 patients with early stage breast cancer were retrospectively evaluated in the study. Patients underwent sentinel node mapping using combined radiotracer and blue dye techniques. Lymphoscintiraphy was also performed for 590 patients. Blue dye, radioisotope, and overall success rates in identifying the sentinel lymph node were evaluated in different patient groups. The benefit of blue dye and radioisotope in identifying the sentinel lymph nodes was also evaluated. RESULTS: Marginal benefits of both blue dye and isotope for overall sentinel node detection as well as pathologically involved sentinel nodes were statistically higher in inexperienced surgeons and in patients with sentinel node visualization failure. In the patients with sentinel node visualization on lymphoscintigraphy, 6 sentinel nodes were detected by blue dye only. All these six nodes were harvested by inexperienced surgeons. On the other hand 8 sentinel nodes were detected by dye only in the patients with sentinel node non-visualization. All these nodes were harvested by experienced surgeons. CONCLUSIONS: The use of blue dye should be reserved for inexperienced surgeons during their learning phase and for those patients in whom lymphoscintigraphy failed to show any uptake in the axilla.