Sentinel lypmh node biopsy in early breast cancer: preliminary results of the combined technique of CT lymphography and blue-dye

Abstract

Aim: The aim of this study was to evaluate the efficacy of CT lymphography in sentinel lymph node biopsy for early stage breast cancer and to investigate its contribution to the conventional blue-dye method. Material and Method: A total of 47 patients with early stage breast cancer underwent preoperative CT lymphography for lymph node mapping before sentinel lymph node biopsy with blue-dye method. The lymph nodes identified by CT lymphography and/or blue-dye method were examined for metastatic involvement. The sentinel lymph node detection rates of CT lymphography and blue-dye method were compared using t-tests. Results: The sentinel lymph node detection rate with blue-dye method (87.2%) was significantly higher than with CT lymphography (66.0%) (P=0.027). However, the combined method (blue-dye method and/or CT lymphography) increased the detection rate (95.7%) (P=0.267). Benign sentinel lymph nodes were detected more often with CT lymphography (P=0.366), while metastatic sentinel lymph nodes were detected more often with blue-dye method (P=1,000). Upper outer quadrant tumors were detected less successfully with CT lymphography and more successfully with blue-dye method (P=0.220 and P=0.674, respectively). The success rate of CT lymphography in younger patients (less than 50 years old) was higher compared to older patients (P=0.001). Conclusion: CT lymphography was found to be insufficient as a standalone method for sentinel lymph node biopsy. However, it could be used as a complementary method to blue-dye method to increase the success of sentinel lymph node detection.