title: A prospective comparative study to assess the contribution of radioisotope tracer method to dye-only method in the detection of sentinel lymph node in breast cancer.
abstract: 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, the total numbers of lymph nodes removed and their metastatic states were determined separately.
  
  
  RESULTS
  At least one blue-stained sentinel lymph node was identified in all patients during the blue-stained lymph node detection stage. The average number of sentinel nodes removed at this stage was 2.1 ± 1.1. In the second surgical stage (the stage in which nodes with axillary counts were investigated with the gamma probe) in these 41 patients, at least one additional hot node was removed, or at least one of the nodes that was removed because it was blue was also hot. In addition to the lymph nodes removed in the dye stage, 34 hot lymph nodes were excised from 21 patients. Overall, the average number of hot lymph nodes removed was 2.9 ± 1.5. In all patients, subsequent frozen sections and histopathological examinations were 100% concordant with the sentinel lymph nodes that were removed; the stained sentinel lymph nodes that were removed first did not affect the decision to perform axillary dissection.
  
  
  CONCLUSIONS
  The results of our study indicate that performing sentinel lymph node biopsy with dye only is sufficient and as effective as the combined method.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Eser
authors.forename: Metin
authors.initials: M
authors.lastname: Kement
authors.forename: Levent
authors.initials: L
authors.lastname: Kaptanoglu
authors.forename: Melin
authors.initials: M
authors.lastname: Gecer
authors.forename: Evrim
authors.initials: E
authors.lastname: Abamor
authors.forename: Firat
authors.initials: F
authors.lastname: Tutal
authors.forename: Salim
authors.initials: S
authors.lastname: Balin
authors.forename: Necmi
authors.initials: N
authors.lastname: Kurt
authors.forename: Huseyin
authors.initials: H
authors.lastname: Uzun
mesh_terms: D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology*; D004396:Coloring Agents; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*
chemical_list: D004396:Coloring Agents; D019275:Radiopharmaceuticals