Sentinel lymphnode biopsy in early breast cancer using methylene blue dye and radioactive sulphur colloid — a single institution Indian experience
Identifieur interne : 003889 ( Pmc/Checkpoint ); précédent : 003888; suivant : 003890Sentinel lymphnode biopsy in early breast cancer using methylene blue dye and radioactive sulphur colloid — a single institution Indian experience
Auteurs : S. P. Somashekhar [Inde] ; S. Zaveri Shabber [Inde] ; K. Udupa Venkatesh [Inde] ; K. Venkatachala [Inde] ; M. M. Vasan Thirumalai [Inde]Source :
- The Indian Journal of Surgery [ 0972-2068 ] ; 2008.
Abstract
Axillary lymph node dissection is an established procedure in breast cancer staging. However, it is associated with unpleasant side effects. A promising alternative to assess axillary lymph node status in early breast cancer patients is Sentinel Lymph Node Biopsy (SLNB). Isosulfan blue has traditionally been the dye used to identify the Sentinel Lymph Node (SLN). This article is a validation study of SLNB using methylene blue dye and radioactive sulphur colloid in early breast cancer Indian patients.
With written informed consent, 100 patients with cytology or biospy proven carcinoma breast, clinical stage T1/ T2 N0 M0, underwent SLNB using combination of methylene blue dye & radioactive technetium 99m sulphur colloid as a part of validation study from June 2003 to February 2006. After validation study, from March 2006 to February 2007, 35 patients have undergone SLNB followed by complete axillary clearance in only those patients with SLNB being positive for metastases.
In all 100 patients of the validation study SLN was identified. Total number of cases with positive axillary nodes was 27, out of which SLN was only positive node for metastases in 69% of cases. The overall sensitivity, specificity, positive predictive valve and negative predictive valve of SLNB 96.2%, 100%, 100% and 98.6% respectively with false negative rate of 3.7%. In subsequent 35 patients who underwent SLNB followed by complete axillary clearance, SLNs was identified in all the cases.
SLNB is effective in early breast cancer patients of Indian population. SLNB using combination of methylene blue dye and radio-active Tc99m sulphur colloid can stage the axilla with high accuracy & low risk of false negativity in early breast cancer patients.
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DOI: 10.1007/s12262-008-0033-9
PubMed: 23133037
PubMed Central: 3452444
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Zaveri Shabber</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Surgical Oncology, Manipal Comprehensive Cancer Centre, Manipal Hospital, Airport Road, Bangalore, 560 017 India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Surgical Oncology, Manipal Comprehensive Cancer Centre, Manipal Hospital, Airport Road, Bangalore</wicri:regionArea><wicri:noRegion>Bangalore</wicri:noRegion></affiliation></author><author><name sortKey="Udupa Venkatesh, K" sort="Udupa Venkatesh, K" uniqKey="Udupa Venkatesh K" first="K." last="Udupa Venkatesh">K. Udupa Venkatesh</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Surgical Oncology, Manipal Comprehensive Cancer Centre, Manipal Hospital, Airport Road, Bangalore, 560 017 India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Surgical Oncology, Manipal Comprehensive Cancer Centre, Manipal Hospital, Airport Road, Bangalore</wicri:regionArea><wicri:noRegion>Bangalore</wicri:noRegion></affiliation></author><author><name sortKey="Venkatachala, K" sort="Venkatachala, K" uniqKey="Venkatachala K" first="K." last="Venkatachala">K. Venkatachala</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Surgical Oncology, Manipal Comprehensive Cancer Centre, Manipal Hospital, Airport Road, Bangalore, 560 017 India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Surgical Oncology, Manipal Comprehensive Cancer Centre, Manipal Hospital, Airport Road, Bangalore</wicri:regionArea><wicri:noRegion>Bangalore</wicri:noRegion></affiliation></author><author><name sortKey="Vasan Thirumalai, M M" sort="Vasan Thirumalai, M M" uniqKey="Vasan Thirumalai M" first="M. M." last="Vasan Thirumalai">M. M. 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P." last="Somashekhar">S. P. Somashekhar</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Surgical Oncology, Manipal Comprehensive Cancer Centre, Manipal Hospital, Airport Road, Bangalore, 560 017 India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Surgical Oncology, Manipal Comprehensive Cancer Centre, Manipal Hospital, Airport Road, Bangalore</wicri:regionArea><wicri:noRegion>Bangalore</wicri:noRegion></affiliation></author><author><name sortKey="Zaveri Shabber, S" sort="Zaveri Shabber, S" uniqKey="Zaveri Shabber S" first="S." last="Zaveri Shabber">S. Zaveri Shabber</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Surgical Oncology, Manipal Comprehensive Cancer Centre, Manipal Hospital, Airport Road, Bangalore, 560 017 India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Surgical Oncology, Manipal Comprehensive Cancer Centre, Manipal Hospital, Airport Road, Bangalore</wicri:regionArea><wicri:noRegion>Bangalore</wicri:noRegion></affiliation></author><author><name sortKey="Udupa Venkatesh, K" sort="Udupa Venkatesh, K" uniqKey="Udupa Venkatesh K" first="K." last="Udupa Venkatesh">K. Udupa Venkatesh</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Surgical Oncology, Manipal Comprehensive Cancer Centre, Manipal Hospital, Airport Road, Bangalore, 560 017 India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Surgical Oncology, Manipal Comprehensive Cancer Centre, Manipal Hospital, Airport Road, Bangalore</wicri:regionArea><wicri:noRegion>Bangalore</wicri:noRegion></affiliation></author><author><name sortKey="Venkatachala, K" sort="Venkatachala, K" uniqKey="Venkatachala K" first="K." last="Venkatachala">K. Venkatachala</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Surgical Oncology, Manipal Comprehensive Cancer Centre, Manipal Hospital, Airport Road, Bangalore, 560 017 India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of Surgical Oncology, Manipal Comprehensive Cancer Centre, Manipal Hospital, Airport Road, Bangalore</wicri:regionArea><wicri:noRegion>Bangalore</wicri:noRegion></affiliation></author><author><name sortKey="Vasan Thirumalai, M M" sort="Vasan Thirumalai, M M" uniqKey="Vasan Thirumalai M" first="M. M." last="Vasan Thirumalai">M. M. Vasan Thirumalai</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Department of General Surgery, Manipal Hospital, Airport Road, Bangalore, 560 017 India</nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Department of General Surgery, Manipal Hospital, Airport Road, Bangalore</wicri:regionArea><wicri:noRegion>Bangalore</wicri:noRegion></affiliation></author></analytic><series><title level="j">The Indian Journal of Surgery</title><idno type="ISSN">0972-2068</idno><idno type="eISSN">0973-9793</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Axillary lymph node dissection is an established procedure in breast cancer staging. However, it is associated with unpleasant side effects. A promising alternative to assess axillary lymph node status in early breast cancer patients is Sentinel Lymph Node Biopsy (SLNB). Isosulfan blue has traditionally been the dye used to identify the Sentinel Lymph Node (SLN). This article is a validation study of SLNB using methylene blue dye and radioactive sulphur colloid in early breast cancer Indian patients.</p></sec><sec><title>Materials & Methods</title><p>With written informed consent, 100 patients with cytology or biospy proven carcinoma breast, clinical stage T1/ T2 N0 M0, underwent SLNB using combination of methylene blue dye & radioactive technetium 99m sulphur colloid as a part of validation study from June 2003 to February 2006. After validation study, from March 2006 to February 2007, 35 patients have undergone SLNB followed by complete axillary clearance in only those patients with SLNB being positive for metastases.</p></sec><sec><title>Results</title><p>In all 100 patients of the validation study SLN was identified. Total number of cases with positive axillary nodes was 27, out of which SLN was only positive node for metastases in 69% of cases. The overall sensitivity, specificity, positive predictive valve and negative predictive valve of SLNB 96.2%, 100%, 100% and 98.6% respectively with false negative rate of 3.7%. In subsequent 35 patients who underwent SLNB followed by complete axillary clearance, SLNs was identified in all the cases.</p></sec><sec><title>Conclusions</title><p>SLNB is effective in early breast cancer patients of Indian population. SLNB using combination of methylene blue dye and radio-active Tc99m sulphur colloid can stage the axilla with high accuracy & low risk of false negativity in early breast cancer patients.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Indian J Surg</journal-id><journal-id journal-id-type="iso-abbrev">Indian J Surg</journal-id><journal-title-group><journal-title>The Indian Journal of Surgery</journal-title></journal-title-group><issn pub-type="ppub">0972-2068</issn><issn pub-type="epub">0973-9793</issn><publisher><publisher-name>Springer-Verlag</publisher-name><publisher-loc>India</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23133037</article-id><article-id pub-id-type="pmc">3452444</article-id><article-id pub-id-type="publisher-id">33</article-id><article-id pub-id-type="doi">10.1007/s12262-008-0033-9</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject></subj-group></article-categories><title-group><article-title>Sentinel lymphnode biopsy in early breast cancer using methylene blue dye and radioactive sulphur colloid — a single institution Indian experience</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Somashekhar</surname><given-names>S. P.</given-names></name><address><phone>+91 / 80 / 25023339</phone><fax>+91 / 80 / 25023759</fax><email>somusp@yahoo.com</email></address><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Zaveri Shabber</surname><given-names>S.</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Udupa Venkatesh</surname><given-names>K.</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Venkatachala</surname><given-names>K.</given-names></name><xref ref-type="aff" rid="Aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Parameshwaran</surname></name><xref ref-type="aff" rid="Aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Vasan Thirumalai</surname><given-names>M. M.</given-names></name><xref ref-type="aff" rid="Aff3">3</xref></contrib><aff id="Aff1"><label>1</label>Department of Surgical Oncology, Manipal Comprehensive Cancer Centre, Manipal Hospital, Airport Road, Bangalore, 560 017 India</aff><aff id="Aff2"><label>2</label>Deparment of Nuclear Medicine, Manipal Hospital, Airport Road, Bangalore, 560 017 India</aff><aff id="Aff3"><label>3</label>Department of General Surgery, Manipal Hospital, Airport Road, Bangalore, 560 017 India</aff></contrib-group><pub-date pub-type="epub"><day>24</day><month>7</month><year>2008</year></pub-date><pub-date pub-type="ppub"><month>6</month><year>2008</year></pub-date><volume>70</volume><issue>3</issue><fpage>111</fpage><lpage>119</lpage><history><date date-type="received"><day>17</day><month>3</month><year>2007</year></date><date date-type="accepted"><day>15</day><month>5</month><year>2008</year></date></history><permissions><copyright-statement>© Association of Surgeons of India 2008</copyright-statement></permissions><abstract id="Abs1"><sec><title>Background</title><p>Axillary lymph node dissection is an established procedure in breast cancer staging. However, it is associated with unpleasant side effects. A promising alternative to assess axillary lymph node status in early breast cancer patients is Sentinel Lymph Node Biopsy (SLNB). Isosulfan blue has traditionally been the dye used to identify the Sentinel Lymph Node (SLN). This article is a validation study of SLNB using methylene blue dye and radioactive sulphur colloid in early breast cancer Indian patients.</p></sec><sec><title>Materials & Methods</title><p>With written informed consent, 100 patients with cytology or biospy proven carcinoma breast, clinical stage T1/ T2 N0 M0, underwent SLNB using combination of methylene blue dye & radioactive technetium 99m sulphur colloid as a part of validation study from June 2003 to February 2006. After validation study, from March 2006 to February 2007, 35 patients have undergone SLNB followed by complete axillary clearance in only those patients with SLNB being positive for metastases.</p></sec><sec><title>Results</title><p>In all 100 patients of the validation study SLN was identified. Total number of cases with positive axillary nodes was 27, out of which SLN was only positive node for metastases in 69% of cases. The overall sensitivity, specificity, positive predictive valve and negative predictive valve of SLNB 96.2%, 100%, 100% and 98.6% respectively with false negative rate of 3.7%. In subsequent 35 patients who underwent SLNB followed by complete axillary clearance, SLNs was identified in all the cases.</p></sec><sec><title>Conclusions</title><p>SLNB is effective in early breast cancer patients of Indian population. SLNB using combination of methylene blue dye and radio-active Tc99m sulphur colloid can stage the axilla with high accuracy & low risk of false negativity in early breast cancer patients.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Sentinel lymph node biopsy</kwd><kwd>Methylene blue dye</kwd><kwd>Tc99m radioactive sulfur colloid</kwd><kwd>Early breast cancer</kwd><kwd>Indian patients</kwd></kwd-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© Association of Surgeons of India 2008</meta-value></custom-meta></custom-meta-group></article-meta></front></pmc><affiliations><list><country><li>Inde</li></country></list><tree><country name="Inde"><noRegion><name sortKey="Somashekhar, S P" sort="Somashekhar, S P" uniqKey="Somashekhar S" first="S. P." last="Somashekhar">S. P. Somashekhar</name></noRegion><name sortKey="Udupa Venkatesh, K" sort="Udupa Venkatesh, K" uniqKey="Udupa Venkatesh K" first="K." last="Udupa Venkatesh">K. Udupa Venkatesh</name><name sortKey="Vasan Thirumalai, M M" sort="Vasan Thirumalai, M M" uniqKey="Vasan Thirumalai M" first="M. M." last="Vasan Thirumalai">M. M. Vasan Thirumalai</name><name sortKey="Venkatachala, K" sort="Venkatachala, K" uniqKey="Venkatachala K" first="K." last="Venkatachala">K. Venkatachala</name><name sortKey="Zaveri Shabber, S" sort="Zaveri Shabber, S" uniqKey="Zaveri Shabber S" first="S." last="Zaveri Shabber">S. Zaveri Shabber</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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