Role of Sentinel Lymph Node Biopsy and Axillary Node Sampling as a Prognostic Marker in Breast Cancer

Abstract

1 M.S (Surgery), Associate Professor, Department of Surgery, Vardhman Institute of Medical Science, Nalanda Bihar, India Email: [email protected] 2 M. S (Surgery), 2 nd yr. PG student, Department of Surgery, Nalanda Medical College, Patna, Bihar, India 3 M.S (Surgery), Senior Resident, Department of Surgery, Nalanda Medical College, Patna, Bihar, India *Corresponding Author Dr Ranvijay Bharti M.S (Surgery), 2 nd year PG. Student, Department of Surgery, Flat no 5, block 1, New PG doctors hostel, IDH Colony, Agamkuan, Nalanda Medical College, Patna, Bihar, India. Email: [email protected] Abstract This study aims to assess whether a combination of sentinel lymph node biopsy (SLNB) using patent blue dye and axillary node sampling (ANS) offers equivalent identification rate to dual tracer technique. Furthermore, we aim to investigate whether there are any potential benefits to this combined technique. Retrospective study of 250 clinically node-negative patients undergoing breast conserving surgery for single T1-T3 tumours between April 2017 and not 2018. Axillary lymph node were staged using a combined blue dye SLNB/ANS technique. SLNs were localized in 245/250 (identification rate 98 %). Three of one hundred ninety patients with a negative SLN were found to have positive ANS nodes and 1/4 failed SLNB patients had positive ANS nodes. Forty of two hundred thirty five patients had SLN metastases and 13/40(32.5%) also had a positive non-sentinel lymph node on ANS. Twenty two of twenty five (88 %) node positive. T1 tumours had single node involvement. Ten of forty node-positive patients progressed to complete axillary clearance (cALND) and the rest were treated with axillary radiotherapy. Axillary recurrence was nil at median 5 year follow-up. Complementing SLNB with axillary node sampling (ANS) decreases the unavoidable false negative rate associated with SLNB. Appropriate operator experience and technique can result in an SLN localization rate of 98.5%..The additional insight offered by ANS into the status of non-sentinel nodes has potential applications in an era of less frequent cALND.