الفهرس 
Evaluation of 1% methylene blue dye in sentinel lymph node biopsy post- neo adjuvant chemotherapy
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Abstract
Background: Surgical management of the axilla in breast cancer has evolved greatly in the last 20 years. SLNB which was first investigated in the early 1990s, has replaced routine axillary lymph node dissection (ALND) with its associated greater morbidity in early stage node negative patients.However, the role and timing of SLNB, management of the axilla, and technical aspects of the procedure in patients treated with neo-adjuvant chemotherapy (NACT) are matters of controversy. Although data on SLNB and NACT are accumulating, the value of SLNB in relation to long-term outcomes remains to be seen. Objectives: Evaluation of the use of 1% Methylene Blue die as a single agent tracer for the detection of sentinel lymph node (SLN) after neoadjuvant chemotherapy for locally advanced breast cancer (LABC) with the calculation of the identification rate and false negative rates (FNRs), compared to other single tracers used in SLN in LABC. Methods: Thirty-one patients with cT₃-₄ (a-c) cN₁-₃, M0breast cancer post NACT who have shown downstaging of their nodal status (N0) were injected 1% methylene blue, retroarelarly orperitumoraly followed by axillary lymph node dissection and results compared to detect FNR, and identification rate. Results: The median age of the patients was 48 with 83.8% of the patients above the age of 40. Identification rate was found to be 83%, a false negative rate of 11.5% was detected. FNRs were found to be less when more than 3 SLNs were dissected, with no statistically significant difference of FNRs related to the initial nodal state of the disease. Conclusion: The use of 1% MB in post NACT showed a comparable identification rate and FNRs to other single tracer techniques, yet all single tracer techniques are lesser than ideal in this group of patients