Outcomes of Sentinel Lymph Node Biopsy Using Blue Dye Method for Early Breast Cancer – A Single-Institution Experience in the Philippines
Received 12 December 2019
Accepted for publication 26 February 2020
Published 11 March 2020 Volume 2020:12 Pages 37—44
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Professor Pranela Rameshwar
Ralph Victor Yap, Frances Marion De La Serna
Department of Surgery, Cebu Doctors’ University Hospital, Cebu City, Cebu, Philippines
Correspondence: Ralph Victor Yap
Department of Surgery, Cebu Doctors’ University Hospital, Osmeña Boulevard, Cebu City 6000, Cebu, Philippines
Tel +63 917 130 1923
Fax +63 32 255 5555
Purpose: This study aimed to share our experience with SLNB in the Filipino population with early breast cancer.
Patients and Methods: A retrospective review was done on all patients with confirmed invasive breast carcinoma, tumor size of 5 cm or less (T1/T2), who preoperatively had no clinical signs of axillary metastasis and subsequently underwent SLNB with blue dye method from January 01, 2008 to December 31, 2017. Clinicopathologic profiles were recorded. Outcomes of patients who had SLNB only were assessed.
Results: One hundred twenty-nine patients matched the inclusion criteria with a mean age of 54.3 years. The majority (88.4%) had a total mastectomy. Invasive ductal carcinoma (65.1%) was the most common tumor. Estrogen and progesterone receptors were positive in 69% and 61.2% respectively while only 28.7% were HER2 positive. SLNB was successfully carried out in 126 (97.7%) patients with a range of 2– 4 SLNs harvested. Thirty-four (26.4%) patients had completion ALND. With a median of 25 months follow-up, 75 out of 95 patients who underwent SLNB alone had follow-up data. Forty-six (61.3%) patients had seroma formation. One (1.3%) patient developed arm paresthesia, 2 (2.7%) local (chest wall) and 2 (2.7%) axillary recurrences after a negative SLNB. None of the patients developed lymphedema.
Conclusion: The blue dye method alone is acceptable and can be readily employed in institutions with limited resources. Even with the limited population, the morbidity and oncologic outcomes of patients who underwent SLNB alone were low and comparable to similar international published data. SLNB should be the preferred method for staging the axilla.
Keywords: breast cancer, Philippines, SLNB, outcomes, sentinel, blue dye
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