Value of Blue Dye as A Single Tracer for Sentinel Lymph Node Biopsy in Breast Cancer ._CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LI Taiyu , SUN Xiao ,  WANG Yongsheng , CHEN Peng , WANG Chunjian , ZHOU Zhengbo , MA Chuandong , LIU Yanbing

Breast Cancer Center, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan 250117, China;

Corresponding author：

WANG Yongsheng, Email: wangysh2008@yahoo.com.cn

Keywords：

Breast cancer; Sentinel lymph node biopsy; Blue dye

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the clinical value of only using blue dye as tracer in the sentinel lymph node biopsy (SLNB) of breast cancer. Methods SLNB was performed with the guidance of the combination of blue dye and isotope in all patients enrolled. SLNB data of blue dye only, and the combination method was recorded respectively for analyses. Results Three hundred and eight patients were enrolled in this prospective study. Significant differences were found in the identification rate (IDR, 93.5% vs. 99.4%, P=0.000), the false negative rate (FNR, 14.8% vs. 3.3%, P=0.007), the accuracy rate (AR, 89.6% vs. 97.8%, P=0.006), and the negative predictive value (NPV, 74.0% vs. 93.3%, P=0.012) between the blue dye alone and the combination method. The IDR and the FNR of the two methods were not significantly associated with the patient age, tumor size and location, histopathological type, type of biopsy and breast surgery, or ER, PR, and HER-2 status (all P gt;0.05). The FNR of blue dye alone was significantly associated with clinically suspicious turgescence of axillary lymph nodes (P=0.042) and decreased followed by the increased number of sentinel lymph nodes obtained (P=0.000). Conclusions Compared with the combination method, SLNB guided with blue dye alone had significantly poorer IDR, AR, and NPV, and higher FNR. It is recommended that the combination of dye and isotope should be adopted for the guidance of SLNB in clinical practice rather than the use of blue dye alone.

Citation： LI Taiyu,SUN Xiao,WANG Yongsheng,CHEN Peng,WANG Chunjian,ZHOU Zhengbo,MA Chuandong,LIU Yanbing. Value of Blue Dye as A Single Tracer for Sentinel Lymph Node Biopsy in Breast Cancer .. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(12): 1235-1239. doi: Copy

1.	Banerjee M, George J, Song EY, et al. Tree-based model for breast cancer prognostication [J]. J Clin Oncol, 2004; 22(13): 2567-2575.
2.	Ciafrocca M, Goldstein LJ. Prognostic and predictive factors on early-stage breast cancer [J]. Oncologist， 2004； 9(6): 606-616.
3.	王永胜. 乳腺癌前哨淋巴结的研究进展 [J]. 中国普外基础与临床, 2005; 12(3): 212-215.
4.	王永胜. 乳腺癌前哨淋巴结活检: 共识与展望 [J]. 中国普外基础与临床, 2009; 16(7): 505-509.
5.	Lyman GH, Giuliano AE, Somerfield MR, et al. American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer [J]. J Clin Oncol, 2005； 23(30): 7703-7720.
6.	Posther KE, Wilke LG, Giuliano AE. Sentinel lymph node dissection and the current status of American trials on breast lymphatic mapping [J]. Semin Oncol, 2004； 31(3): 426-436.
7.	Giuliano AE. Intradermal blue dye to identify sentinel lymph node in breast cancer [J]. Lancet， 1997； 350(9082): 958.
8.	Krag D, Weaver D, Ashikaga T, et al. The sentinel node in breast cancer-a multicenter validation study [J]. N Engl J Med， 1998； 339(14): 941- 946.
9.	Giuliano AE. Sentinel lymphadenectomy in primary breast carcinoma: an alternative to routine axillary dissection [J]. J Surg Oncol， 1996； 62(2): 75-77.
10.	Goldhirsch A, Ingle JN, Gelber RD, et al. Thresholds for therapies: highlights of the St Gallen International Expert Consensus on the primary therapy of early breast cancer 2009 [J]. Ann Oncol, 2009; 20(8): 1319-1329.
11.	Simmons R, Thevarajah S, Brennan MB, et al. Methylene blue dye as an alternative to isosulfan blue dye for sentinel lymph node localization [J]. Ann Surg Oncol, 2003； 10(3): 242-247.
12.	Nour A. Efficacy of methylene blue dye in localization of sentinel lymph node in breast cancer patients [J]. Breast J, 2004； 10(5): 388-391.
13.	Blessing WD, Stolier AJ, Teng SC, et al. A comparison of methylene blue and lymphazurin in breast cancer sentinel node mapping [J]. Am J Surg, 2002； 184(4): 341-345.
14.	Eldrageely K, Vargas MP, Khalkhali I, et al. Sentinel lymph node mapping of breast cancer: a case-control study of methylene blue tracer compared to isosulfan blue [J]. Am Surg, 2004； 70(10): 872-875.
15.	Varghese P, Mostafa A, Abdel-Rahman AT, et al. Methylene blue dye versus combined dye-radioactive tracer technique for sentinel lymph node localisation in early breast cancer [J]. Eur J Surg Oncol, 2007； 33(2): 147-152.
16.	Martin RC 2nd, Chagpar A, Scoggins CR, et al. Clinicopathologic factors associated with false-negative sentinel lymph-node biopsy in breast cancer [J]. Ann Surg， 2005; 241(6): 1005-1012； discussion 1012-1015.
17.	Veronesi U, Paganelli G, Viale G, et al. A randomized comparision of sentinel-node biopsy with routine axiIlary dissection in breast cancer [J]. N Engl J Med, 2003； 349(6): 546-553.
18.	任兆增, 杨耿侠，王磊, 等. 乳腺癌前哨淋巴结活检放射安全性的研究 [J]. 中华肿瘤防治杂志， 2007； 14(16): 1241-1243.
19.	Cremonesi M, Ferrari M, Sacco E, et al. Radiation protection in radioguided surgery of breast cancer [J]. Nucl Med Commun, 1999； 20(10): 919-924.
20.	Sener SF, Winchester DJ, Brinkmann E, et al. Failure of sentinel lymph node mapping in patients with breast cancer [J]. J Am Coll Surg, 2004; 198(5): 732-736.
21.	Giuliano AE, Kirgan DM, Guenther JM, et al. Lymphatic mapping and sentinel lymphadenectomy for breast cancer [J]. Ann Surg, 1994； 220(3): 391-398.
22.	Wong SL, Edwards MJ, Chao C, et al. Sentinel lymph node biopsy for breast cancer: impact of the number of sentinel node removed on the false-negative rate [J]. J Am Coll Surg, 2001; 192(6): 684-689.
23.	黄晓燕, 吴炅, 刘哲斌, 等. 亚甲蓝示踪在乳腺癌前哨淋巴结活检中的应用及影响因素 [J]. 癌症, 2007; 26(10): 1133-1137.
24.	Krag D, Weaver D, Askikaga T, et al. The sentinel node in breast cancer multicenter validation study [J]. N Engl J Med, 1998; 339(14): 941-946.
25.	刘哲斌, 吴炅, 黄晓燕, 等. 乳腺癌前哨淋巴结活检中亚甲蓝与亚甲蓝、同位素联合示踪的比较研究 [J]. 中华普通外科杂志, 2007; 22(11): 840-843.

1. Banerjee M, George J, Song EY, et al. Tree-based model for breast cancer prognostication [J]. J Clin Oncol, 2004; 22(13): 2567-2575.
2. Ciafrocca M, Goldstein LJ. Prognostic and predictive factors on early-stage breast cancer [J]. Oncologist， 2004； 9(6): 606-616.
3. 王永胜. 乳腺癌前哨淋巴结的研究进展 [J]. 中国普外基础与临床, 2005; 12(3): 212-215.
4. 王永胜. 乳腺癌前哨淋巴结活检: 共识与展望 [J]. 中国普外基础与临床, 2009; 16(7): 505-509.
5. Lyman GH, Giuliano AE, Somerfield MR, et al. American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer [J]. J Clin Oncol, 2005； 23(30): 7703-7720.
6. Posther KE, Wilke LG, Giuliano AE. Sentinel lymph node dissection and the current status of American trials on breast lymphatic mapping [J]. Semin Oncol, 2004； 31(3): 426-436.
7. Giuliano AE. Intradermal blue dye to identify sentinel lymph node in breast cancer [J]. Lancet， 1997； 350(9082): 958.
8. Krag D, Weaver D, Ashikaga T, et al. The sentinel node in breast cancer-a multicenter validation study [J]. N Engl J Med， 1998； 339(14): 941- 946.
9. Giuliano AE. Sentinel lymphadenectomy in primary breast carcinoma: an alternative to routine axillary dissection [J]. J Surg Oncol， 1996； 62(2): 75-77.
10. Goldhirsch A, Ingle JN, Gelber RD, et al. Thresholds for therapies: highlights of the St Gallen International Expert Consensus on the primary therapy of early breast cancer 2009 [J]. Ann Oncol, 2009; 20(8): 1319-1329.
11. Simmons R, Thevarajah S, Brennan MB, et al. Methylene blue dye as an alternative to isosulfan blue dye for sentinel lymph node localization [J]. Ann Surg Oncol, 2003； 10(3): 242-247.
12. Nour A. Efficacy of methylene blue dye in localization of sentinel lymph node in breast cancer patients [J]. Breast J, 2004； 10(5): 388-391.
13. Blessing WD, Stolier AJ, Teng SC, et al. A comparison of methylene blue and lymphazurin in breast cancer sentinel node mapping [J]. Am J Surg, 2002； 184(4): 341-345.
14. Eldrageely K, Vargas MP, Khalkhali I, et al. Sentinel lymph node mapping of breast cancer: a case-control study of methylene blue tracer compared to isosulfan blue [J]. Am Surg, 2004； 70(10): 872-875.
15. Varghese P, Mostafa A, Abdel-Rahman AT, et al. Methylene blue dye versus combined dye-radioactive tracer technique for sentinel lymph node localisation in early breast cancer [J]. Eur J Surg Oncol, 2007； 33(2): 147-152.
16. Martin RC 2nd, Chagpar A, Scoggins CR, et al. Clinicopathologic factors associated with false-negative sentinel lymph-node biopsy in breast cancer [J]. Ann Surg， 2005; 241(6): 1005-1012； discussion 1012-1015.
17. Veronesi U, Paganelli G, Viale G, et al. A randomized comparision of sentinel-node biopsy with routine axiIlary dissection in breast cancer [J]. N Engl J Med, 2003； 349(6): 546-553.
18. 任兆增, 杨耿侠，王磊, 等. 乳腺癌前哨淋巴结活检放射安全性的研究 [J]. 中华肿瘤防治杂志， 2007； 14(16): 1241-1243.
19. Cremonesi M, Ferrari M, Sacco E, et al. Radiation protection in radioguided surgery of breast cancer [J]. Nucl Med Commun, 1999； 20(10): 919-924.
20. Sener SF, Winchester DJ, Brinkmann E, et al. Failure of sentinel lymph node mapping in patients with breast cancer [J]. J Am Coll Surg, 2004; 198(5): 732-736.
21. Giuliano AE, Kirgan DM, Guenther JM, et al. Lymphatic mapping and sentinel lymphadenectomy for breast cancer [J]. Ann Surg, 1994； 220(3): 391-398.
22. Wong SL, Edwards MJ, Chao C, et al. Sentinel lymph node biopsy for breast cancer: impact of the number of sentinel node removed on the false-negative rate [J]. J Am Coll Surg, 2001; 192(6): 684-689.
23. 黄晓燕, 吴炅, 刘哲斌, 等. 亚甲蓝示踪在乳腺癌前哨淋巴结活检中的应用及影响因素 [J]. 癌症, 2007; 26(10): 1133-1137.
24. Krag D, Weaver D, Askikaga T, et al. The sentinel node in breast cancer multicenter validation study [J]. N Engl J Med, 1998; 339(14): 941-946.
25. 刘哲斌, 吴炅, 黄晓燕, 等. 乳腺癌前哨淋巴结活检中亚甲蓝与亚甲蓝、同位素联合示踪的比较研究 [J]. 中华普通外科杂志, 2007; 22(11): 840-843.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Value of Blue Dye as A Single Tracer for Sentinel Lymph Node Biopsy in Breast Cancer .

Abstract Full text Figures/Tables Video References Cited by

Format

Content