Clinical Research Of Carbon Nanoparticles Suspension And Methylene Blue In Sentinel Lymph Node Biopsy For Breast Cancer

Objective:To evaluate the clinical value of carbon nanoparticles (CNP) suspension and methylene blue (MB) as tracers in the sentinel lymph node biopsy (SLNB) for breast cancer. To investigate the factors that influence the detection rate of SLNB.Methods:A total of 375 breast cancer patients from January 2013 to December 2014 performed SLNB were analyzed retrospectively. According to different dye tracers used, patients were classified into CNP group and MB group. Compared the detection rate, number of SLNs identified, false negative rate (FNR) and positive rate in these 2 groups, and analyzed the correlation between number of SLNs identified and axillary lymph node metastasis. Investigated the factors affected the detection rate include patient characteristics, tumor characteristics and previous excision method.Results:Among 191 cases in the CNP group,189 cases were successful detected SLN, with the detection rate of 99.0%. In the MB group,172 of 184 cases were successful detected SLN, with the detection rate of 93.5%. The detection rate of CNP group is significantly higher than MB group (P<0.05). In the CNP group,985 SLNs were stained, with an average of 5.2 per patient.615 stained SLNs were identified in the MB group, the mean number is 3.6 per patient. The differences of these 2 groups were statistically significant (P<0.05). The FNR and positive rate of these 2 groups showed no statistics significant differ. There was no correlation between the number of SLNs identified and positive rate (P>0.05).Positive correlation was observed between the number of positive SLNs identified and non-SLN metastasis rate (correlation coefficients: 1.00, P=0.000). The detection rates of 2 groups were not significantly associated with the tumor size, location, molecular subtypes, patient age, BMI or previous excision biopsy (all P>0.05).Conclusions:The CNP is an excellent lymph node tracer with higher detection rate and more SLNs identified-in SLNB for breast cancer patient compared to MB. The FNR and positive rate of these 2 tracers have no statistical differences. There is positive correlation between non-SLN metastasis rate and the number of positive SLNs identified. Tumor size, location, molecular subtypes, patient age, BMI or previous excision biopsy do not affect the detection rate of SLNB performed with MB or CNP.