BACKGROUND:
Axillary lymph node status is a vital prognostic indicator in the prognosis of the patients with carcinoma breast. Sentinel lymph node biopsy being a standard of approach in early breast cancers with negative axilla. However there exists a debate regarding the role of sentinel lymph node biopsy after Neo adjuvant chemotherapy in locally advanced breast malignancies. This study assesses the feasibility, efficacy & accuracy of sentinel lymph nodes using Methylene blue dye following NAC in locally advanced breast cancers.
METHOD:
This is a prospective study where 30 patients admitted to our hospital with carcinoma breast, who met with the inclusion and exclusion criteria, were subjected to clinical examination and relevant investigations. Patients were given three cycles of neo-adjuvant chemotherapy followed by standard MRM (level II clearance) during which sentinel lymph node mapping done. The results are evaluated and analyzed.
RESULTS:
Thus in our study, Sentinel node dissection was attempted in 30 patients, out of which sentinel nodes were successfully identified in 28 patients, with a sentinel node identification rate of 93%. We achieved a sensitivity of 85.7% (12/14), specificity of > 99.9%, true positive rate of 39.4%, false negative rate of 14.3% (2/18), a negative predictive value of 88.8% (16/18). None of the patients in our study developed any complications.
CONCLUSION:
sentinel lymph node biopsy is feasible and efficacious in locally advanced breast cancer after neo-adjuvant chemotherapy.
The Accuracy rate, Identification rate and False negative values of this study are comparable to the node negative breast cancer patients.
Majority of carcinoma breast patients are post-menopausal age group
