Malhotra Chanchal, Pawar Richa, Patni Sanjeev, Kaushik Mitesh, Sharma Nivedita
Department of Oncosurgery, Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, Rajasthan India.
Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana India.
Indian J Surg Oncol. 2021 Mar;12(1):119-123. doi: 10.1007/s13193-020-01235-y. Epub 2020 Sep 25.
Sentinel lymph node biopsy using dual methods of blue dye and radioactive isotope is what is practised as the standard of care at most of the centres. The combined use of radioactive colloid and blue dye injection is considered the gold standard for axillary sentinel lymph node biopsy in breast cancer with a 97% accuracy rate. The aim of this study is to determine the optimal injection site for methylene blue dye and Tc99-labelled sulphur colloid for sentinel lymph node biopsy in early breast cancer. In both periareolar and peritumoral groups of patients, overall rate of identifying sentinel lymph node (hot, blue and hot and blue nodes) with dual dye was comparable (100% and 96.36%) with value = 0.475. Also in both groups of patients, overall rate of getting pathological positive sentinel lymph node on final histopathological report was comparable (52.73% and 45.28%) with value = 0.561. Periareolar versus peritumoral injection of dual dye shows comparable success rates for axillary sentinel lymph node identification and can be considered rapid and reliable method. However, the periareolar route is technically simple and especially privileged in nonpalpable (T0) and upper outer quadrant lesions mainly for the prevention of the shine through phenomenon.
使用蓝色染料和放射性同位素双重方法进行前哨淋巴结活检是大多数中心所采用的标准治疗方法。放射性胶体与蓝色染料联合注射被认为是乳腺癌腋窝前哨淋巴结活检的金标准，准确率达97%。本研究的目的是确定早期乳腺癌前哨淋巴结活检中，亚甲蓝染料和锝99标记硫胶体的最佳注射部位。在乳晕周围和肿瘤周围两组患者中，双重染料识别前哨淋巴结（热、蓝及热且蓝的淋巴结）的总体率相当（分别为100%和96.36%），P值 = 0.475。在两组患者中，最终组织病理学报告中前哨淋巴结病理阳性的总体率也相当（分别为52.73%和45.28%），P值 = 0.561。乳晕周围与肿瘤周围双重染料注射在腋窝前哨淋巴结识别方面成功率相当，可被视为快速可靠的方法。然而，乳晕周围途径技术上简单，尤其在不可触及（T0）及外上象限病变中具有优势，主要是为了防止穿透现象。
