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Outcome of single tracer methylene blue for breast cancer sentinel lymph node biopsy in resource-limited country

Abstract

Introduction: Sentinel lymph node biopsy (SLNB) has been developed as a new early-stage breast cancer management method. In developing countries, SLNB tracer that is relatively easy to obtain and less expensive is intravenous Methylene blue (MB). This study aimed to evaluate the outcome of SLNB using MB tracer (MB-SLNB) compared to axillary lymph node dissection (ALND) in early-stage breast cancer patients in terms of survival and complications.

Methods: This study was a retrospective cohort that was carried out in Jakarta, Indonesia, at the Cipto Mangunkusumo Hospital and the Metropolitan Medical Center Hospital. MB-SLNB or ALND operations performed on female patients with early-stage breast cancer between January 2015 and June 2019 were included in our study. For every SLNB operation, Metiblo®, a methylene blue agent, was used. Five years after the operation, survival is the main result.

Results: The study had 78 patients in total; 21 (26.9%) received MB-SLNB and 57 (73.1%) underwent ALND. After correcting for possible confounders, we saw no difference in the two groups' overall 5-year survival rates (100 vs. 90.5%; log-rank test p-value = 0.573 and HR 0.63 95%CI 0.07-5.58; p-value = 0.674). There was no discernible change in the frequency of recurrence or complications. In addition, there was no arm pain or breast skin oversensitivity in the SLNB patients.

Conclusions: The MB-SLNB procedure is not inferior to conventional ALND for the 5-year survival and recurrence event parameters. SLNB shall stand as the standard of care for early-stage breast cancer patients as long as it can be supported to be widely accessible in resource-limited countries.

References

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How to Cite

Panigoro, S. S., Sobri, F. B., Wibisana, I. G. N. G., Gustada, H., Halim, O. N., & Harinda, F. (2024). Outcome of single tracer methylene blue for breast cancer sentinel lymph node biopsy in resource-limited country. Bali Medical Journal, 13(3), 978–983. https://doi.org/10.15562/bmj.v13i3.4732

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Sonar Soni Panigoro
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Farida Briani Sobri
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I Gusti Ngurah Gunawan Wibisana
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Hardya Gustada
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Odetta Natatilova Halim
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