EXPERIENCE WITH LYMPHATIC MAPPING IN BREAST-CANCER USING ISOSULFAN BLUE-DYE

Sentinel (first tumor-draining) lymph node (SLN) biopsy directed by th e blue dye technique may be as accurate as complete axillary lymph nod e dissection (ALND) in determining whether breast cancer has metastasi zed to the lymph nodes and may have fewer surgical complications becau se it is less invasive. Breast cancer patients scheduled for ALND betw een February and June 1997 who did not have prior axillary surgery, pr ior radiation therapy, or preoperative chemotherapy were included. Iso sulfan blue dye was injected around the primary tumor or the biopsy ca vity just before ALND. Operations were performed in a tertiary breast center by two breast surgeons who did not have experience with the tec hnique before this study. The results of blue stained nodes were compa red to those of the ALND. Blue-stained nodes were identified in 35 of 40 patients (88%), and the results were concordant with ALND in 33 of 35 (94%), 7 patients were concordant for positive results and 26 for n egative results. We identified SLNs in patients whose cancers were eit her in the medial or lateral halves of the breast. Average time for SL N dissection was 19 +/- 9 minutes, and there were no complications. Th e diagnostic accuracy of the isosulfan blue dye technique for SLN biop sy, 94%, is high enough to warrant further research. The lack of compl ications and the short time needed to perform the technique are attrac tive features. Broader experience with the technique is required to ev aluate the reliability and reproducibility of this method.