Indian Journal of Nuclear Medicine

ORIGINAL ARTICLE
Year
: 2022  |  Volume : 37  |  Issue : 3  |  Page : 236--244

Sentinel node mapping in early breast cancer: A randomized comparison of fluorescein guided all india institute of medical sciences, anurag's technique with technetium-99 m sulfur colloid plus methylene blue


Sarada Khadka1, Jayesh Suresh2, Amar Prem3, Piyush Ranjan Mishra2, Kamal Kataria2, Anita Dhar2, Vuthaluru Seenu2, Chandershekhar Bal4, Rakesh Kumar4, Sandeep Mathur5, Smriti Hari6, Ravindra Mohan Pandey7, Anurag Srivastava2 
1 Department of Surgery, BP Koirala Institute of Health Sciences, Dharan, Nepal
2 Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India
3 Mahamana Madam Mohan Malviya Cancer Centre, Varanasi, Uttar Pradesh, India
4 Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
5 Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
6 Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
7 Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Prof. Anurag Srivastava
Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi
India

Purpose: Evaluation of fluorescein along with blue dye as an affordable tracer for sentinel node biopsy in comparison with technetium + methylene blue. A randomized trial was conducted with the following objectives: (1) to demonstrate that the identification of sentinel lymph node by fluorescein + methylene blue is not inferior to the identification by Tc-99 m sulfur colloid + methylene blue and (2) to evaluate the cost-effectiveness of sentinel node biopsy by above two tracers. Subjects and Methods: One-thirty patients above age 18 years presenting with early breast cancer T1, T2, N0 breast carcinoma were randomized to undergo sentinel node biopsy by either fluorescein + methylene blue or Tc-99 m sulfur colloid + methylene blue. Results: The sentinel lymph nodes were identified in 89% in Fluorescein + methylene blue group and 90.9% with Tc-99 m sulfur colloid + methylene blue group. The trial demonstrated noninferiority of fluorescein + methylene blue as compared to isotope + methylene blue with effect size = 1; 95% confidence interval- 9.54 to + 11.54. The fluorescein + methylene blue was more cost-effective than isotope guided sentinel node biopsy. Conclusion: Fluorescein-guided sentinel node biopsy is noninferior and more cost-effective than isotope-guided sentinel node biopsy.


How to cite this article:
Khadka S, Suresh J, Prem A, Mishra PR, Kataria K, Dhar A, Seenu V, Bal C, Kumar R, Mathur S, Hari S, Pandey RM, Srivastava A. Sentinel node mapping in early breast cancer: A randomized comparison of fluorescein guided all india institute of medical sciences, anurag's technique with technetium-99 m sulfur colloid plus methylene blue.Indian J Nucl Med 2022;37:236-244


How to cite this URL:
Khadka S, Suresh J, Prem A, Mishra PR, Kataria K, Dhar A, Seenu V, Bal C, Kumar R, Mathur S, Hari S, Pandey RM, Srivastava A. Sentinel node mapping in early breast cancer: A randomized comparison of fluorescein guided all india institute of medical sciences, anurag's technique with technetium-99 m sulfur colloid plus methylene blue. Indian J Nucl Med [serial online] 2022 [cited 2022 Dec 1 ];37:236-244
Available from: https://www.ijnm.in/article.asp?issn=0972-3919;year=2022;volume=37;issue=3;spage=236;epage=244;aulast=Khadka;type=0