title: Sentinel lymph node identification by blue dye in patients with breast carcinoma.
abstract: OBJECTIVE
  To determine the diagnostic accuracy of methylene blue dye to detect axillary lymph node metastases in patients with breast carcinoma by taking histopathology as gold standard.
  
  
  METHODS
  This quasi experimental study was done at Department of Surgery of Dow University Hospital Karachi during January 2013 to September 2015 after the approval of Hospital Ethical Committee. A total number of 85 patients with biopsy proven carcinoma were included in the study.1% methylene blue dye was infiltrated in the peri tumoural area of the diseased breast. The blue stained node called sentinel lymph node (SLN) was recognized and carefully dissected out. SLN and mastectomy with axillary clearance specimen was sent for histopathology in two separate bottles and the report of the histopathology was compared.
  
  
  RESULTS
  The axillary lymph nodes were positive for carcinoma in 61 cases out of 85(71.7%). Two of the patients had negative sentinel lymph node but positive non sentinel lymph node (false negative), and in three cases sentinel lymph node were involved only but not the rest of the axilla (False positive). The sensitivity, specificity and accuracy were 96.8%,86.36% and 94.1% respectively.
  
  
  CONCLUSIONS
  Methylene blue dye technique is a reliable and safe diagnostic modality for detection of Sentinel lymph node in breast cancer patient because of its high accuracy.
authors.affiliation: Dr. Nighat Bakhtiar, MBBS. Post Graduate General Surgery Fellowship Trainee, Department of Surgery, Dow International Medical College/ Dow University Hospital, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Nighat
authors.initials: N
authors.lastname: Bakhtiar
authors.affiliation: Dr. Farhat Jaleel, MBBS, FCPS (General Surgery). Associate Professor, Department of Surgery, Dow International Medical College/ Dow University Hospital, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Farhat
authors.initials: F
authors.lastname: Jaleel
authors.affiliation: Prof. Foad Ali Moosa, MBBS, FRCS. Professor & Head of Department of Surgery, Dow International Medical College/ Dow University Hospital, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Foad Ali
authors.initials: FA
authors.lastname: Moosa
authors.affiliation: Dr. Naeem Akhtar Qureshi, MBBS, FCPS (General Surgery). Assistant Professor, Department of Surgery, Dow International Medical College/ Dow University Hospital, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Naeem Akhtar
authors.initials: NA
authors.lastname: Qureshi
authors.affiliation: Dr. Masood Jawaid, MBBS, MCPS, MRCS, FCPS (General Surgery), MHPE Visiting Faculty, University of Health Sciences, Lahore, Pakistan.
authors.forename: Masood
authors.initials: M
authors.lastname: Jawaid
keywords: Breast cancer; Diagnostic accuracy; Methylene blue; Sentinel lymph nod