Combined Fluorescein and Methylene Blue Dye for Sentinel Lymph Node Biopsy in Patients of Early Carcinoma Breast: A Promising Technique

Indian J Surg Oncol. 2024 Dec;15(4):891-900. doi: 10.1007/s13193-024-01976-0. Epub 2024 Jul 4.

Abstract

Sentinel lymph node biopsy is currently the gold standard for clinically node-negative patients of carcinoma breast. Fluorescein is a safe, low-cost agent, and easily available. Fluorescein has shown a promising role in sentinel lymph node evaluation in carcinoma breast in combination with methylene blue dye with a detection rate of more than 90% and a false-negative rate of less than 10% in previous studies. This study aims to determine the detection rate and diagnostic accuracy of fluorescein and methylene blue dye in early breast cancer. The identification rate and false-negative rate of the combined blue and fluorescent dye method were 100% and 7.14% respectively. The accuracy of the combined blue and fluorescein dye method was 98.3%. The sensitivity, specificity, negative predictive value, and positive predictive value of the combined blue dye and fluorescein dye method were 92.8%, 100%, 97.8%, and 100% respectively. Thus, the combined blue and fluorescein dye method is an easy, safe, cost-effective, and reliable method of sentinel lymph node biopsy in early breast cancer patients.

Keywords: Axillary lymph node dissection; Early breast carcinoma; Fluorescein; Methylene blue dye; Sentinel lymph node biopsy.