Comparison of sentinel lymph node biopsy versus four node sampling for management of carcinoma breast
Journal Title: Medpulse International Journal of Surgery - Year 2018, Vol 5, Issue 3
Abstract
Background: Breast cancer is the leading malignancy, and the second leading cause of cancer related deaths. It is well established that axillary lymph node status is a very important prognostic factor in breast cancer patients; nodal evaluation by axillary lymph node dissection (ALND) has been an integral component in the surgical treatment of invasive breast cancer. A sentinel lymph node (SLN) is defined as the first lymph node to which a primary tumour drains. Axillary nodal sampling (ANS) also called four node sampling is a technique in which at least four palpable lymph nodes were removed from axillary tail or lower axillary fat. Present study is done to compare efficacy of sentinel lymph node biopsy (SLNB) and axillary in assessing nodal metastasis in Carcinoma breast. Material and Methods: This randomized controlled study was carried out in department of general surgery, in a tertiary care hospital. It included patients who underwent sentinel lymph node biopsy and four node sampling during study period. Every alternate patient was subjected to sentinel lymph node biopsy and with four node sampling, In patient which are subjected to Sentinel lymph node biopsy, Isosulphan blue dye will be injected intralesion and perilesional 20 minutes prior to surgery. Results: Sentinel lymph node biopsy has a sensitivity of 90.48%, specificity of 85.71%, positive predictive value as 90.48%, negative predictive value as 85.71% and overall accuracy of SNB was 88.57%. while Four node sampling has a sensitivity of 75%, specificity of 61.54%, positive predictive value as 75%, negative predictive value as 61.54% and overall accuracy was 65.71%. Conclusion: Accuracy of Sentinel lymph node biopsy (88.57%) is more than that of Four node sampling (65.71 %).Sentinel lymph node was located mostly in level I and second most commonly in level II. Incidence for skip metastasis is 9.52%.
Authors and Affiliations
Hemant Chaudhari, Milind S Chaudhari
Keywords
Related Articles
- EP ID EP478583
- DOI 10.26611/106531
- Views 172
- Downloads 0
Study of risk factors and clinical manifestations of peptic perforations and peritonitis
Background: Peptic ulcer perforation and secondary peritonitis forms one of the commonest and most important causes of acute abdominal emergency, which the general surgeon has to deal with. Knowledge of risk factors and...
Conventional hemorrhoidectomy and stapled hemorrhoidectomy: A clinical comparative study
Background: Though hemorrhoid disease is one of the most common causes of anal pathology usually the patients are embarrassed to seek medical help. Various studies have estimated that symptomatic hemorrhoids affect more...
A comparative study of laparoscopic with open incisional hernia repair
Incisional Hernia repair has been one of the most commonly performed surgeries by the general surgeons. The most significant advances to impact Incisional Hernia repair have been the addition of the prosthetic materials...
A study of different modalities in treatment of lower limb varicose veins
Background: Varicose veins and their associated symptoms and complications constitute chronic vascular disorders leading to surgical treatment. In developing countries like India, study encompassing the clinical evaluati...
A study of role of limberg flap for Sacro-Coccygeal pilonidal sinus
Background: Sacro-Coccygeal pilonidal sinus is a common disease of the adult age group, especially male population, causing significant morbidity from both disease and surgery done for the same. It is essentially a cleav...