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Validation of Sentinel Lymph Node Biopsy Technique Using Dual Tracer Technique in Post Lumpectomy Early Breast Cancer Patients

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Abstract

Sentinel lymph node biopsy (SLNB) is the gold standard for the evaluation of axilla in clinically node-negative early breast cancers. There is limited data on the role and efficacy of the same in the post lumpectomy scenario. This prospective interventional study was conducted over 1 year on 30 post lumpectomy pT1/2 cN0 patients. SLNB was performed by preoperative lymphoscintigram using technetium-labeled human serum albumin followed by intraoperative blue dye injection. Sentinel nodes were identified based on blue dye uptake and gamma probe and sent for intra operative frozen section. Completion axillary nodal dissection was performed in all cases. The primary end point was sentinel node identification rate and accuracy of nodal frozen section. Sentinel node identification rate was 86.7% (n = 26/30) for scintigraphy alone and 96.7% (n = 29/30) using combined method. Average sentinel nodal yield/patient was 3.6 (range 0–7). Maximum yield was seen for hot and blue nodes (1.86). Sensitivity (n = 9/9) and specificity (n = 19/19) of frozen section were 100% with a false negative rate of 0% (0/19). Demographic factors such as age, body mass index, laterality, quadrant, biology, grade, and pathological T stage had no impact on the identification rate. Sentinel lymph node using dual tracer has a high identification rate and a low false negative rate post lumpectomy. Age, body mass index, laterality, quadrant, grade, biology, and pathological T size had no impact on the identification rate.

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Funding

Regional Cancer Centre (RCC), Medical College Campus, Trivandrum, Kerala, India. 695011.

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Authors and Affiliations

  1. Department of Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, 695011, India

    Paul Augustine & Rexeena V. Bhargavan

  2. Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, Telangana, 500034, India

    Sridhar Dasu

  3. Department of Pathology, Regional Cancer Centre, Thiruvananthapuram, Kerala, 695011, India

    Sindhu P. Nair

  4. Department of Nuclear Medicine, Regional Cancer Centre, Thiruvananthapuram, Kerala, 695011, India

    V. M. Pradeep

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  1. Paul Augustine
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  2. Sridhar Dasu
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  3. Sindhu P. Nair
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  4. Rexeena V. Bhargavan
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  5. V. M. Pradeep
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Correspondence to Paul Augustine.

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The study was cleared by institutional review board and ethics committee and is registered with Clinical Trials Registry- India (CTRI/2014/08/004920).

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Augustine, P., Dasu, S., Nair, S.P. et al. Validation of Sentinel Lymph Node Biopsy Technique Using Dual Tracer Technique in Post Lumpectomy Early Breast Cancer Patients. Indian J Surg Oncol 14, 434–439 (2023). https://doi.org/10.1007/s13193-020-01242-z

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  • DOI: https://doi.org/10.1007/s13193-020-01242-z

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