title: Sentinel Lymph Node Detection Using Carbon Nanoparticles in Patients with Early Breast Cancer.
abstract: OBJECTIVE
  Carbon nanoparticles have a strong affinity for the lymphatic system. The purpose of this study was to evaluate the feasibility of sentinel lymph node biopsy using carbon nanoparticles in early breast cancer and to optimize the application procedure.
  
  
  METHODS
  Firstly, we performed a pilot study to demonstrate the optimized condition using carbon nanoparticles for sentinel lymph nodes (SLNs) detection by investigating 36 clinically node negative breast cancer patients. In subsequent prospective study, 83 patients with clinically node negative breast cancer were included to evaluate SLNs using carbon nanoparticles. Another 83 SLNs were detected by using blue dye. SLNs detection parameters were compared between the methods. All patients irrespective of the SLNs status underwent axillary lymph node dissection for verification of axillary node status after the SLN biopsy.
  
  
  RESULTS
  In pilot study, a 1 ml carbon nanoparticles suspension used 10-15min before surgery was associated with the best detection rate. In subsequent prospective study, with carbon nanoparticles, the identification rate, accuracy, false negative rate was 100%, 96.4%, 11.1%, respectively. The identification rate and accuracy were 88% and 95.5% with 15.8% of false negative rate using blue dye technique. The use of carbon nanoparticles suspension showed significantly superior results in identification rate (p = 0.001) and reduced false-negative results compared with blue dye technique.
  
  
  CONCLUSIONS
  Our study demonstrated feasibility and accuracy of using carbon nanoparticles for SLNs mapping in breast cancer patients. Carbon nanoparticles are useful in SLNs detection in institutions without access to radioisotope.
authors: Department of Surgery, Fujian Provincial Tumor Hospital, Teaching Hospital of Fujian Medical University, Fuzhou 350014, Fujian, People's Republic of China.
authors: Xiufeng
authors: X
authors: Wu
authors: Department of Surgery, Fujian Provincial Tumor Hospital, Teaching Hospital of Fujian Medical University, Fuzhou 350014, Fujian, People's Republic of China.
authors: Qingzhong
authors: Q
authors: Lin
authors: Department of Pathology, Fujian Provincial Tumor Hospital, Teaching Hospital of Fujian Medical University, Fuzhou 350014, Fujian, People's Republic of China.
authors: Gang
authors: G
authors: Chen
authors: Department of Pathology, Fujian Provincial Tumor Hospital, Teaching Hospital of Fujian Medical University, Fuzhou 350014, Fujian, People's Republic of China.
authors: Jianping
authors: J
authors: Lu
authors: Department of Surgery, Fujian Provincial Tumor Hospital, Teaching Hospital of Fujian Medical University, Fuzhou 350014, Fujian, People's Republic of China.
authors: Yi
authors: Y
authors: Zeng
authors: Department of Surgery, Fujian Provincial Tumor Hospital, Teaching Hospital of Fujian Medical University, Fuzhou 350014, Fujian, People's Republic of China.
authors: Xia
authors: X
authors: Chen
authors: Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong, People's Republic of China.
authors: Jun
authors: J
authors: Yan
mesh_terms: D000328:Adult; D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D002244:Carbon / Q000008:administration & dosage*; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D018275:Carcinoma, Lobular / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D042241:Early Diagnosis; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D007271:Injections, Intradermal; D008198:Lymph Nodes / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008751:Methylene Blue / Q000008:administration & dosage; D008875:Middle Aged; D053758:Nanoparticles / Q000008:administration & dosage*; D009367:Neoplasm Staging; D010865:Pilot Projects; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy
chemical_list: D002244:Carbon; D008751:Methylene Blue