Authors : Sulata Choudhury, Siba Prasad Dash, V Rajesh, Subhabrata Das, Chandan Das
DOI : 10.18231/j.pjms.2023.047
Volume : 13
Issue : 1
Year : 2023
Page No : 241-245
Introduction: Sentinel lymph node biopsy (SLNB) has become standard to stage the axilla in cases of clinically and Ultrasound negative axilla avoiding unnecessary axillary Lymph node dissection which is associated with higher morbidity in patients
Objective: 1. The Primary objective is to preoperatively detect axillary metastasis in USG confirmed node negative axilla and perform Sentinel Lymph node Biopsy, 2. To negate the need for axillary lymph node dissection and biopsy in the treatment of breast cancer patients with sentinel node negative
Materials and Methods: A total number of 80 patients with core needle biopsy proved were subjected to USG of Breast and axilla. The patients who had suspicious features in USG axilla were subjected to USG Guided FNAC. The patient having positive (metastasis) over USG guided FNAC were subjected to ALND and those patients with USG guided FNAC Negative and Normal USG Axilla i.e. No suspicious over USG were subjected to SLNB using blue dye. The SLNB negative cases were followed up with Adjuvant Chemotherapy and every 3months in combination with sonography of the breast and the axilla. Mammograms, X-ray and abdominal sonography performed annually.
Results: All 80 biopsy proven patients were subjected to USG. From which 32 patients had suspicious of metastatic deposits which were subjected to USG Guided FNAC. Rest 48 patients Normal Axilla. From 32 suspicious patients undergone USG Guided FNAC 15 showed deposits in Axilla which were subjected to ALND. Rest 17 Negative under USG guided FNAC along with 48 Normal Axilla patients were subjected to blue dye SLNB i.e., Total of 65 cases. i). From these 65 cases which undergone SLNB 4 cases (23.5%) showed metastatic deposit in USG guided FNAC Negative cases (17 total cases) and 8 cases (16.6%) showed metastatic deposit in USG Normal Axilla (48 Total cases) in frozen section. Which brings total SLNB of 18.4% (12 out of 65 cases). ii). These 12 cases were subjected to Axillary Lymph node dissection. The Final HPE study showed 100% metastatic deposits. iii). Remaining 53 cases were followed up for a period of 12 months. No local or Axillary recurrence could be observed in 53 patients who underwent SLNB without ALND.
Conclusion: Short term results were very promising with combination of USG along with SLNB without ALND in SLNB negative cases and holds a strong future perspective.
Keywords: Sentinel Lymph node biops, FNAC