The Long-term Safety And Prognosis Analysis Of Tracer Sentinel Lymph Node Biopsy Using Indocyanine Green And Methylene Blue In Breast Cancer

Objectives: The aim of the study is analyze the recurrence,metastasis and prognosis of early breast cancer patients and evaluate the long-term safety of tracer sentinel lymph node biopsy using indocyanine green and methylene blue in early breast cancer.Objectives: The aim of the study is investigate the long-term follow-up results and safety of indocyanine green(ICG)combined with methylene blue for double tracer technique of sentinel lymph node biopsy(SLNB),and to analyze the characteristics of recurrence and metastasis as well as the prognosis of these patients with early breast cancer.Methods:1.the long-term follow-up results and safety of double tracer techniqueA total of 222 breast cancer patients were enrolled consecutively in our hospital from January 1,2014 to December 31,2014.According to the adverse events,patients were divided into two group.The clinical data of the patients were analyzed.(1)Experimental group: In this group,sentinel lymph nodes are positive or no sentinel lymph nodes were detected,and axillary lymph node dissection was performed in 70 patients.(2)Control group: Sentinel lymph nodes were negative and no axillary lymph node dissection was performed in 152 patients.By comparing the local recurrence,regional lymph node metastasis,distant metastasis,disease-free survival and overall survival of the two groups 5 years after surgery,the difference between the two groups was analyzed,so as to provide evidence for the long-term safety of sentinel lymph node biopsy with double tracer technique.2.Analysis of prognostic factorsPatients were divided into two groups according to whether postoperative adverse events occurred in the enrolled patients.(1)Recurrence group: 24 patients with adverse events.(2)No recurrence group: 198 patients without adverse events.By analyzing the baseline data and clinicopathological characteristics of the two groups of patients,the risk factors affecting the prognosis of patients were evaluated.Results:1.The five years follow up results were compared between patients.The median follow-up time was 57 months of 222 patients.(1)Local recurrence: The local recurrence rates of 152 patients without ALND and 70 patients with ALND were not statistically significant,0.7%(1/152)vs 1.4%(1/70),P=0.576.(2)Regional lymph node metastasis:The regional lymph node metastasis rates of SLNB and ALND groups were not statistically significant,0(0/152)vs 1.4%(1/70)P=0.231.(3)Distant metastasis:The distant metastasis rates of SLNB and ALND groups were statistically significant,5.3%(8/152)vs 15.7%(11/70)P=0.010.(4)Death;The death rates of SLNB and ALND groups were not statistically significant,5.3%(8/152)vs 7.1%(5/70)P=0.579.(5)The disease-free survival rates:The disease-free survival rates of one year、three years and five years for SLNB and ALND groups were not statistically significant,the 1-year disease-free survival rate 100%(152/152)vs 100%(70/70),P=1.000;the 3-year disease-free survival rate 96.7%(147/152)vs 95.6%(67/70),P=0.711;the 5-year disease-free survival rate 90.8%(138/152)vs 85.7%(60/70),P=0.258.(6)The overall survival rate: the overall survival rate of one year、three years and five years for SLNB and ALND groups were not statistically significant,the 1-year overall survival rate 100%(152/152)vs 100%(70/70),P=1;the 3-year overall survival rate 98.0%(149/152)vs 9.1%(68/70),P=0.680;the 5-year overall survival rate 94.7%(144/152)vs 92.9%(65/70),P=0.579.(7)The overall survival rate of all the patients:the overall survival rate of 1-year、3-year、5-year were 100%(222/222)、96.4%(214/222)、89.2%(198/222).(8)The overall survival for all patients:the overall survival for all patients 1-year、3-year、5-year were 100%(222/222)、96.8%(215/222)、94.1%(209/222).2.The analysis of prognostic factors.The multivariate Cox regression model found that: the age of the patient ≤50,tree-negative molecular classification and primary tumor which is larger than 2 cm were independent risk factors for breast cancer with HR of 3.254(95%CI:1.086-9.748)、7.321(95%CI:2.958-18.116)and 3.507(95%CI:1.118-10.355)(all P<0.05).Conclusions:1.ICG combined with MB use double tracer technique for SLNB has reliable axillary control rate and long-term safety,it is worth of clinical promotion.2.The COX regression models showed that age、the size of primary tumor and three-negative molecular type were independent risk factors for prognosis of breast cancer patients.