A new optical probe for the detection of the sentinel lymph node using patent blue V dye in breast cancer: A preliminary study (original) (raw)
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2020
BACKGROUND: Sentinel lymph node (SNL) biopsy in breast cancer for the determination of axillary status is standard procedures in surgical treatment of early-stage breast cancer. The identification of the SNL is usually performed by radiocolloid injection or/and injection of methylene blue due. The use of indocyanine green (ICG) dye, which is fluorescent dye, which movement in breast and axillar pit, can be followed with special cameras which detect near infrared specatar of light. CASE REPORT: In this paper, we present case report of patient with breast cancer, where we perform SNL detection with three methods: Use of radiocolloid which we trace with static gamma camera, and intraoperatively with hand held gamma probe, methylene blue dye which movement we followed by eye contact and using indocyanine green which movement was followed by specially constructed multispectral camera, which can detect near-infrared fluorescence that is emitted by ICG and methyline blue, respectively. CON...
Journal of Cancer Science and Clinical Therapeutics, 2019
Background: A sentinel lymph node (SLN) is considered to be the first lymph node which is draining the tumor site. Radioactive Tc-99m labeled sulfur colloid, vital blue dye such as isosulfan blue or methylene blue, or the combination of the both is generally used for sentinel lymph node localization. In this study, we compare the sensitivity of both the methods to establish an effective method for SLN localization among early cases of breast cancer. Methods: Forty incidental cases, consulting the hospital between Jan 2015-June 2017 and diagnosed with early breast cancer (Stage T1N0M0 and T2N0M0) were subjected to sentinel lymph node detection by both radiocolloid and dye. 99m Tc-labeled are filtered sulfur colloid was administered intradermally in the periaerolar region in the tumor quadrant, 30 mins-1 h prior to the surgery. 1ml methylene blue dye, was administered, intraparenchymally, by circumareolar region during the surgery. All radioactive lymph nodes were removed until the background activity was less than one-tenth the ex-vivo value of hottest node. All the blue dye positive nodes, whether or not radiocolloid positive were excised and labeled accordingly and sent for histo-pathological examination.
Annals of Surgical Oncology, 2012
Background. Near-infrared (NIR) fluorescence imaging using indocyanine green (ICG) has the potential to improve sentinel lymph node (SLN) mapping of breast cancer. We performed a randomized clinical trial to assess the value of blue dyes when used in combination with NIR fluorescence. We also preliminarily examined the possibility of performing SLN mapping without radiotracers. Methods. Clinical trial subjects were 24 consecutive breast cancer patients scheduled to undergo SLN biopsy. All patients received standard of care using 99 m technetium-nanocolloid and received 1.6 mL of 500 lM ICG injected periareolarly. Patients were randomly assigned to undergo SLN biopsy with or without patent blue. To assess the need for radiocolloids to localize the SLN or SLNs, the surgeon did not use the handheld gamma probe during the first 15 min after the axillary skin incision. Results. SLN mapping was successful in 23 of the 24 patients. No significant difference was found in signal-tobackground ratio between the groups with and without patent blue (8.3 ± 3.8 vs. 10.3 ± 5.7, respectively, P = 0.32). In both groups, 100 % of SLNs were radioactive and fluorescent, and in the patent blue group, only 84 % of SLNs were stained blue. In 25 % of patients, the use of the gamma probe was necessary to localize the SLN within the first 15 min.
Revista da Associação Médica Brasileira, 2017
Summary Introduction: Methylene blue is more widely available and less expensive than patent blue, with an apparently lower risk of anaphylaxis. Objective: The two dyes were compared regarding detection of the sentinel lymph node (SLN). Method: A prospective, randomized trial involved 142 patients with invasive breast carcinoma. Sixty-nine (49.3%) assigned to patent blue (group A) and 71 (50.70%) to methylene blue (group B). Thirty-five patients (25.0%) were clinical stage III or IV; 55 (38.7%) had axillary lymph nodes affected; and 69 (49.3%) underwent neoadjuvant chemotherapy. Two patients were excluded because the dye type was not recorded. Results: Patients and tumor characteristics were similar in both groups. SLNs were identified in 47 women (68.1%) in group A and 43 (60.6%) in group B (p=0.35). SLNs were affected in 22 cases (51.2%) in group A and 21 (48.8%) in group B (p=0.62). The SLN was the only node affected in 12 cases (54.5%) in group A and six (33.3%) in group B (p=0....
Gland Surgery
Background: Since the end of the last century, sentinel lymph node biopsy (SLNB) has replaced axillary lymph node dissection (ALND) as standard of care for axillary staging in early breast cancer in patients without any clinical sign of axillary lymph node infiltration. The worldwide most frequently used mapping method consists in the injection of radioactive Technetium-99 isotope alone or in combination with blue dye. As a specific infrastructure and dedicated personnel are needed for the use of a radioactive tracer, the CHC in Liege (Belgium) decided to test the use of patent blue dye alone to detect sentinel lymph nodes in a large consecutive cohort of patients and compared the results with radioactive mapping methods and guidelines recommendations. Methods: Patent blue dye was used in 456 consecutive patients with early breast cancer who underwent conservative breast cancer surgery or radical mastectomy between 1/1/2000 and 31/12/2007 in a community hospital (CHC Liège, Belgium). After SLNB, an ALND was performed in each patient. Results: Sentinel lymph nodes were identified in 444 patients among the 456 patients evaluated by this mapping method during this time period, which represents a detection rate of 97.4%. Infiltrated lymph nodes were detected in 32.7% of patients (149/456) while in the 444 patients with sentinel lymph nodes identified and resected, 137 patients have at last one positive lymph node (30.9%). The false negative rate was 4.9% and the predictive negative value was 97.7% with the blue dye mapping method. Conclusions: In addition of the simplicity of the method and the large economic advantage, SNLB using blue dye alone showed a quite acceptable performance in our retrospective analysis concerning its ability to find the SLN as well as its reliability to remove the good ones.
European Journal of Surgical Oncology (EJSO), 2004
Background. Sentinel lymph node biopsy in breast cancer can be used to select patients in which axillary lymph node dissection could be avoided. In this study we compared the value of two methods for identification of sentinel node (SN) using either only blue dye or combination of blue dye and radioactive tracer. Material and methods. All patients were women with clinically T 1K2 N 0 M 0 breast cancer. They were randomized into two groups. In Group A (50 patients) SN marking was performed only with blue dye and in Group B (100 patients) combined SN marking with blue dye and radiotracer was done. We used 2 ml of blue dye Patentblau V w (Byk Gulden). Radiotracer was Antimony sulfide marked with Tc 99m and of 0.3 mCy (11.1 MBq) activity. Application method of both contrasts was peritumoral. After SN biopsy all patients underwent mastectomy or conservative surgery with axillary lymph node dissection of levels I and II. Results. In Group A mean of 1.7 SNs were identified (median 1, range 1-4). Falsenegative rate in this group was 3/17 (17.6%) with negative-predictive value 20/23 (86.9%), sensitivity 14/17 (82%), specificity 20/33 (60%) and accuracy 34/50 (68%). In Group B mean number of SNs excised per case was 1.6 (median 1, range 1-5). Falsenegative rate was 2/44 (4.5%), negative-predictive value 41/43 (95.3%), sensitivity 42/44 (95%), specificity 41/56 (73%) and accuracy 83/100 (83%). The combination technique was significantly superior to blue-dye alone technique for negativepredictive value (pZ0.033) and overall accuracy (pZ0.048).
A Study of Sentinel Lymph Node Biopsy with Methylene Blue Dye in Early Carcinoma of Breast
Journal of Evolution of Medical and Dental Sciences
BACKGROUND Axillary lymph node status is very important prognostic factor in breast carcinoma patients; nodal evaluation is therefore a critical part of breast cancer management. However, axillary lymph node dissection results in significant morbidity. Thus, in the midnineties Sentinel Lymph Node Biopsy (SLNB) was introduced for staging in breast cancer patients. We carried out a study to find out whether the sentinel lymph node initially receives malignant cells from a breast carcinoma and whether a clear sentinel node reliably forecasts a disease-free axilla. MATERIALS AND METHODS Here 68 female patients with pathologically (FNAC/Trucut biopsy) proved early breast cancer without clinically palpable nodes, clinical stage T1/T2 N0M0, admitted in Krishna Institute of Medical Sciences, Karad from October 2014 to June 2016 who were to undergo modified radical mastectomy were selected for this study. Methylene blue dye (5 cc of 1% dye) was injected in subareolar region 20 minutes prior to surgery. The breast was then massaged for 5 minutes. Intraoperatively, sentinel lymph node were searched after raising superior flap. Dissection of axillary tissue to identify stained lymph node was done. All blue nodes and any node receiving a blue lymphatic channel were considered as sentinel nodes. After excising the stained lymph nodes, complete axillary clearance and removal of breast tissue was done. RESULTS Sentinel Lymph Node was identified in 61 cases out of a total of 68 cases in which the procedure was performed with a n identification rate of 89%. The overall sensitivity, specificity, Positive Predictive Value (PPV) and negative predictive value (NPV) of SLNB in predicting axillary node status was 93.33%, 83.87%, 84.84% and 92.85% respectively. A false negative rate of 6.67% was observed. CONCLUSION Our results show that this simplified technique of identifying the sentinel node(s) by using subareolar methylene blue has sufficiently high identification rate (89%). The results of the present study describe our initial experience with the SLNB technique, hence a false negative rate of 6.67% and negative predictive value of 92.85%, both of which are modifiable variables.
BMC Surgery, 2013
Background Metastasis in the axillary lymph nodes is the most important known prognostic factor for breast cancer. We aimed to investigate the contribution of the radioisotope tracer method to the dye-only method by performing sentinel lymph node biopsy on the same patient group during a single surgical session. Methods Forty-two patients who underwent operations in our clinic from February 2010 to October 2011 and with masses of <5 cm and clinically and radiologicallly negative axilla (T1-2 N0) were prospectively included in this study. After paraffin examination results were obtained, the numbers and metastatic states of the lymph nodes that were unidentifiable during surgery (although they were stained) but were detected by a gamma probe, lymph nodes that were only stained, lymph nodes that were only radioactive (hot), and lymph nodes that were both stained and radioactive (stained-hot) were determined in all patients. In patients who underwent axillary lymph node dissection, ...