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Methylene Blue as Inexpensive and Reliable Sole Sentinel Lymph Node Mapping Agent for Patients with Invasive Ductal Carcinoma

BACKGROUND: Invasive ductal cancer (IDC) represents about 75% of all breast malignancies. There are many breast cancer prognostic factors, but the ones that have the most impact on the survival rates in advanced breast cancer are tumor size and regional lymph node involvement. Axillary lymph node di...

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Autores principales: Halilbasic, Emir, Iljazovic, Ermina, Mehmedovic, Zlatan, Brkic, Eldar, Sarkanovic, Goran
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AVICENA, d.o.o., Sarajevo 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8812375/
https://www.ncbi.nlm.nih.gov/pubmed/35210951
http://dx.doi.org/10.5455/msm.2021.33.282-287
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author Halilbasic, Emir
Iljazovic, Ermina
Mehmedovic, Zlatan
Brkic, Eldar
Sarkanovic, Goran
author_facet Halilbasic, Emir
Iljazovic, Ermina
Mehmedovic, Zlatan
Brkic, Eldar
Sarkanovic, Goran
author_sort Halilbasic, Emir
collection PubMed
description BACKGROUND: Invasive ductal cancer (IDC) represents about 75% of all breast malignancies. There are many breast cancer prognostic factors, but the ones that have the most impact on the survival rates in advanced breast cancer are tumor size and regional lymph node involvement. Axillary lymph node dissection (ALND) has particularly important and undoubtful role in current surgical options for breast cancer treatment. With the introduction of sentinel lymph node biopsy (SLNB) for breast cancer patients it was possible to identify those to whom regional spread of the disease did not occur at the time of surgery, and thus spare them an unnecessary ALND procedure. OBJECTIVE: To determine the rate of sentinel lymph node (SLN) detection using only methylene blue dye as a mapping agent, as well as to correlate the number of positive SLNs with the number of positive non-sentinel lymph nodes (non-SLNs). METHODS: The study represents a prospective study that included 50 female patients with histologically confirmed invasive ductal carcinoma (IDC) who underwent SLNB using only methylene blue dye as the mapping agent, while the detection and harvest of SNL was done by visual control only. All patients also underwent an obligatory complete ALND, which was as that time the institutional oncological protocol for surgical treatment of histologically confirmed IDC. The final data such as tumor size, SLN and non-SLN status were obtained by further analysis of pathohistological reports from tumor biopsy and other surgical specimens. RESULTS: The accuracy rate of SLN detection was 98%. The number of detected SLN was in the range of 1 to 6, with an average of 2 for each patient. The number of positive SLN was in significant correlation with the number of tumor-affected non-SNL (p<0,001). Further analysis showed that for each increase in the number of positive SLN by 1, the risk of positive non-SLN increased 6-fold, OR=6,22 (p<0,001). CONCLUSION: Use of methylene blue dye as a sole mapping agent when performing SLNB in patients with IDC is a reliable and effective method that can be safely implemented in medical institutions that lack availability of nuclear medicine services or significant monetary funds.
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spelling pubmed-88123752022-02-23 Methylene Blue as Inexpensive and Reliable Sole Sentinel Lymph Node Mapping Agent for Patients with Invasive Ductal Carcinoma Halilbasic, Emir Iljazovic, Ermina Mehmedovic, Zlatan Brkic, Eldar Sarkanovic, Goran Mater Sociomed Original Paper BACKGROUND: Invasive ductal cancer (IDC) represents about 75% of all breast malignancies. There are many breast cancer prognostic factors, but the ones that have the most impact on the survival rates in advanced breast cancer are tumor size and regional lymph node involvement. Axillary lymph node dissection (ALND) has particularly important and undoubtful role in current surgical options for breast cancer treatment. With the introduction of sentinel lymph node biopsy (SLNB) for breast cancer patients it was possible to identify those to whom regional spread of the disease did not occur at the time of surgery, and thus spare them an unnecessary ALND procedure. OBJECTIVE: To determine the rate of sentinel lymph node (SLN) detection using only methylene blue dye as a mapping agent, as well as to correlate the number of positive SLNs with the number of positive non-sentinel lymph nodes (non-SLNs). METHODS: The study represents a prospective study that included 50 female patients with histologically confirmed invasive ductal carcinoma (IDC) who underwent SLNB using only methylene blue dye as the mapping agent, while the detection and harvest of SNL was done by visual control only. All patients also underwent an obligatory complete ALND, which was as that time the institutional oncological protocol for surgical treatment of histologically confirmed IDC. The final data such as tumor size, SLN and non-SLN status were obtained by further analysis of pathohistological reports from tumor biopsy and other surgical specimens. RESULTS: The accuracy rate of SLN detection was 98%. The number of detected SLN was in the range of 1 to 6, with an average of 2 for each patient. The number of positive SLN was in significant correlation with the number of tumor-affected non-SNL (p<0,001). Further analysis showed that for each increase in the number of positive SLN by 1, the risk of positive non-SLN increased 6-fold, OR=6,22 (p<0,001). CONCLUSION: Use of methylene blue dye as a sole mapping agent when performing SLNB in patients with IDC is a reliable and effective method that can be safely implemented in medical institutions that lack availability of nuclear medicine services or significant monetary funds. AVICENA, d.o.o., Sarajevo 2021-12 /pmc/articles/PMC8812375/ /pubmed/35210951 http://dx.doi.org/10.5455/msm.2021.33.282-287 Text en © 2021 Emir Halilbasic, Ermina Iljazovic, Zlatan Mehmedovic, Eldar Brkic, Goran Sarkanovic https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Paper
Halilbasic, Emir
Iljazovic, Ermina
Mehmedovic, Zlatan
Brkic, Eldar
Sarkanovic, Goran
Methylene Blue as Inexpensive and Reliable Sole Sentinel Lymph Node Mapping Agent for Patients with Invasive Ductal Carcinoma
title Methylene Blue as Inexpensive and Reliable Sole Sentinel Lymph Node Mapping Agent for Patients with Invasive Ductal Carcinoma
title_full Methylene Blue as Inexpensive and Reliable Sole Sentinel Lymph Node Mapping Agent for Patients with Invasive Ductal Carcinoma
title_fullStr Methylene Blue as Inexpensive and Reliable Sole Sentinel Lymph Node Mapping Agent for Patients with Invasive Ductal Carcinoma
title_full_unstemmed Methylene Blue as Inexpensive and Reliable Sole Sentinel Lymph Node Mapping Agent for Patients with Invasive Ductal Carcinoma
title_short Methylene Blue as Inexpensive and Reliable Sole Sentinel Lymph Node Mapping Agent for Patients with Invasive Ductal Carcinoma
title_sort methylene blue as inexpensive and reliable sole sentinel lymph node mapping agent for patients with invasive ductal carcinoma
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8812375/
https://www.ncbi.nlm.nih.gov/pubmed/35210951
http://dx.doi.org/10.5455/msm.2021.33.282-287
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