Dye-guided sentinel node biopsy revisited; validation and observational study from a single institute.
BACKGROUND
The aims of this study were to evaluate the feasibility and accuracy of indigocarmine dye-guided sentinel node biopsy and to apply this method to avoid further axillary node dissection in sentinel node negative cases.


METHODS
Sixty consecutive clinically node-negative breast cancer patients underwent sentinel node biopsy using 0.5% indigocarmine followed by standard axillary node dissection. Sentinel node biopsy was then applied to 42 clinically node-negative patients to avoid axillary node dissection with intraoperative diagnosis made by frozen section.


RESULTS
Validation study: Sentinel nodes were successfully detected in all 60 patients. The mean number of harvested nodes was 1.7 (range 1-3). Sentinel nodes were positive in all 20 axillary node-positive patients, and therefore the false negative rate was 0% (0/20). Only sentinel nodes contained metastases in 55% (11/20) of node positive patients. Observational study: Sentinel nodes were successfully detected in all 42 patients. The mean number of harvested nodes was 1.6 (range 1-3). Sentinel nodes were positive in 12 patients by final histology, and there was one false negative case by frozen section (8%, 1/12). Only sentinel nodes contained metastases in 55% (6/11) of node positive patients. The detection rate, mean number of harvested sentinel nodes and proportion of node positive patients were similar between the validation and observational studies.


CONCLUSIONS
Indigocarmine dye-guided sentinel node biopsy was feasible and accurate. This method can be applied to observational studies after successful validation.
Aihara
Tomohiko
T
Department of Surgery, Kansai Rosai Hospital, 3-1-69, Inabaso, Amagasaki, Hyogo 660-8511, Japan. aiharat@kanrou.net
Takatsuka
Yuichi
Y
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology*; D004396:Coloring Agents; D005260:Female; D006801:Humans; D007203:Indigo Carmine; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy / Q000592:standards*
D004396:Coloring Agents; D007203:Indigo Carmine