breast-cancer-2016_posters-accepted-abstracts

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Volume 8, Issue 8(Suppl) J Cancer Sci Ther
ISSN: 1948-5956 JCST, an open access journal
Page 90
Notes:
Breast Cancer Congress 2016
September 19-21, 2016
conferenceseries.com
Breast Cancer September 19-21, 2016 Phoenix, USA
2nd World Congress on
Targeted four-node sampling of axilla: A simple, reliable and cost-effective approach in the
management of breast cancer
Mandeep Kaur, Chintamani, Mukesh Garg, Manu Kaushik, Manish Kumar Mishra, anju Bansal, Usha Agarwal and Sunita Saxena
Safdarjung Hospital, India
Background: Axillary lymph nodes are surrogate markers for mapping the optimal management of axilla in breast cancer, and
their assessment is pivotal to management and outcome. Until now, the assessment of axillary lymph nodes largely relies upon
sentinel node biopsy (dual method) or conventional lymph node dissection. The morbidity of axillary lymph node dissection
however is well known. Sentinel node biopsy is, thus, considered in a clinically node-negative axilla. However developing
economies face the dilemma and challenges of matching up to the high cost of gamma probe, the vagaries of its learning curve,
and often, the advanced stage of disease at which the patients present. Also, with the advent of neo-adjuvant chemotherapy, the
axilla can be down staged to a node negative status (N0). In this setting, a targeted four-node sampling (FNS) can offer a simple,
reliable and cost-effective approach to the assessment of axilla.
Material &Methods: A total of 160 patients with locally advanced breast cancer who had received neo-adjuvant chemotherapy
from the nucleus of this study. In each patient, axillary mapping was done using peri-areolar injection of 3 ml of methylene
blue dye immediately before surgery. Four blue nodes from the specified anatomical site at level-I were picked up and subjected
to frozen section. The axillary dissection was subsequently completed in a conventional manner in all patients irrespective of
the outcome of frozen section and the entire specimen was sent separately for histopathological examination. The outcome
of frozen section was compared and correlated with the actual histopathological assessment of entire axilla to find out the
sensitivity, specificity, and false negative rates of the technique.
Results: The sensitivity and specificity of FNS were found to be 89.5% and 93.3% respectively. The negative and positive
predictive values were found to be 84.6% and 100% respectively.
Conclusion: It was observed that ‘targeted’ FNS using methylene blue dye can serve as a reliable and inexpensive alternative
to other techniques for addressable of axilla even in locally advanced breast cancers. This is particularly relevant in developing
economies where majority patients still present as locally advanced; and high end facilities, such as gamma camera and isotope
studies, are scarce.
Mandeep Kaur et al., J Cancer Sci Ther 2016, 8:8(Suppl)