The Application Of Sentinel Lymph Node Biopsy In Early Breast Cancer

Objective: To investigate the feasibility and application value of sentinel lymph node biopsy(SLNB) in early breast cancer, Analysis on the differences of SLNB between blue dyeing method and combined method. To explore the effect of clinical characteristics of patients to the detection rate and false negative rate of SLNB. And to evaluate the differences in operations and postoperative complications with different axillary lymph node dissection( ALND).Method: We collected 274 cases of early breast cancer patients in thyroid and breast surgery of Wannan Medical College affiliated yijishan hospital from 2011 January to 2014 June in, 204 cases with blue dye method SLNB and 70 cases with blue dye method combined with indocyanine green fluorescence staining of SLNB. According to frozen pathological results of sentinel lymph nodes(SLN), We take the standard ALND for the patients of SLN positive and the simplified ALND for the patients of SLN Negative(the dissection only for LevelⅠ).Results: 204 cases with blue dye method of SLNB, the success rate was 95.59%, the average detection 1.94±1.743 SLN, false negative rate 8.64%. 70 cases with combined method of SLNB, the success rate was 98.57%, the average detection 2.84±1.922 SLN, false negative rate 10.71%. No statistically significant difference in the comparison of the success rate of the 2 group(P=0.461). There was significant difference between the number of SLN positive(P<0.01). Age, BMI index had significant effects on the detection rate(P<0.05). Age, BMI index and the number of SLN detection had significant effects on the false negative difference(P<0.05). 99 cases of SLN positive patients underwent the standard ALND, and 165 cases of SLN negative patients underwent simplified ALND. The complications of simplified ALND breast cancer such as operation time, postoperative hospitalization time, axillary drainage time were shortened obviously, postoperative axillary seroma, decreased muscle strength, activity limitation, pain, numbness and swelling were decreased obviously. After 3~42 months’ followe up, the patients had no axillary lymph node recurrence and distant metastasis.Conclusion: SLNB of breast cancer can accurately predict the status of axillary lymph node metastasis. Both the blue staining method and combined method of SLNB tracing method are safe and effective. The age of patients, the BMI index had obvious effects on the detection rate, Age, BMI index, the number of detected SLN had obvious effects on the false negative. Compared with the standard radical mastectomy and axillary lymph node dissection for breast cancer, the dissection only for axillary Level I of breast cancer has shortened the operation time, postoperative hospitalization time and axillary drainage time, and reduced the postoperative complications obviously.