COMPARATIVE ANALYSIS OF METHYLENE BLUE DYE IN BREAST CANCER SENTINEL LYMPH NODE BIOPSY

Abstract

Background and aim: Breast cancer, the most prevalent nonskin cancer among women, significantly impacts public health. SLNB offers a minimally invasive alternative to axillary lymph node dissection, reducing complications. This study assesses methylene blue dye's efficacy in SLNB to potentially avoid full axillary dissection. To compare the effectiveness of methylene blue dye in identifying tumor positivity in sentinel lymph node biopsies (SLNB) of breast cancer patients with histopathology results and evaluate if it can eliminate the need for complete axillary dissection. Research design and Methods: This prospective, randomized study was conducted at a tertiary hospital from September 2020 to September 2022. It included 50 female patients aged 25 and older with biopsy-proven breast carcinoma (stages T1N0, T2N0, and T3N0). Exclusion criteria were pregnancy, immunocompromised status, dye allergies, and palpable axillary nodes. Methylene blue dye (2-5 ml of 1% W/V) was injected peri-areolarly, and SLNB was performed. Histopathological examination was conducted on biopsied nodes. Data analysis included sensitivity, false negatives, negative predictive value, and accuracy using SPSS version 24.0. Results: Sentinel nodes were identified in 45 out of 50 patients (90% identification rate). The methylene blue test showed 97.67% sensitivity, a low false negative rate (2%), and a moderate negative predictive value (80%). Conclusion: Methylene blue dye showed high sensitivity and moderate specificity for SLNB in breast cancer patients, suggesting it as a reliable method for staging the axilla while reducing morbidity from axillary lymph node dissection.