Comparison of sentinel lymph node biopsy versus four node sampling for management of carcinoma breast
Journal Title: Medpulse International Journal of Surgery - Year 2018, Vol 5, Issue 3
Abstract
Background: Breast cancer is the leading malignancy, and the second leading cause of cancer related deaths. It is well established that axillary lymph node status is a very important prognostic factor in breast cancer patients; nodal evaluation by axillary lymph node dissection (ALND) has been an integral component in the surgical treatment of invasive breast cancer. A sentinel lymph node (SLN) is defined as the first lymph node to which a primary tumour drains. Axillary nodal sampling (ANS) also called four node sampling is a technique in which at least four palpable lymph nodes were removed from axillary tail or lower axillary fat. Present study is done to compare efficacy of sentinel lymph node biopsy (SLNB) and axillary in assessing nodal metastasis in Carcinoma breast. Material and Methods: This randomized controlled study was carried out in department of general surgery, in a tertiary care hospital. It included patients who underwent sentinel lymph node biopsy and four node sampling during study period. Every alternate patient was subjected to sentinel lymph node biopsy and with four node sampling, In patient which are subjected to Sentinel lymph node biopsy, Isosulphan blue dye will be injected intralesion and perilesional 20 minutes prior to surgery. Results: Sentinel lymph node biopsy has a sensitivity of 90.48%, specificity of 85.71%, positive predictive value as 90.48%, negative predictive value as 85.71% and overall accuracy of SNB was 88.57%. while Four node sampling has a sensitivity of 75%, specificity of 61.54%, positive predictive value as 75%, negative predictive value as 61.54% and overall accuracy was 65.71%. Conclusion: Accuracy of Sentinel lymph node biopsy (88.57%) is more than that of Four node sampling (65.71 %).Sentinel lymph node was located mostly in level I and second most commonly in level II. Incidence for skip metastasis is 9.52%.
Authors and Affiliations
Hemant Chaudhari, Milind S Chaudhari
Keywords
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