66PD - Comparison of blue dye and radio-tracer markers for identification of axillary sentinel node in patients with early breast cancer

Date 19 December 2016
Event ESMO Asia 2016 Congress
Session Breast cancer
Topics Breast Cancer, Early Stage
Imaging, Diagnosis and Staging
Surgery and/or Radiotherapy of Cancer
Presenter Peteris Loza
Citation Annals of Oncology (2016) 27 (suppl_9): ix19-ix29. 10.1093/annonc/mdw575
Authors P. Loza1, J. Eglitis2, K. Arcimovica2
  • 1Breast Surgery, Latvian Oncology Center Rakus Gailezers, LV1014 - Riga/LV
  • 2Breast Health Department, Latvian Oncology Center Rakus Gailezers, 1079 - Riga/LV



Sentinel lymph node biopsy is a standard procedure in treatment of early breast cancer. However, the technique itself and the use of lymphatic markers remain generally unstandardized. Aim of this study is to compare efficacy of sentinel node biopsy using methylene-blue dye, radioactive colloid and dual marker technique.


Prospective study includes patients with early breast cancer treated in a single institution from year 2013 to 2015. Three subgroups were created according to the method of lymphatic marking (A=blue dye, B=radioactive technetium, C=dual markers). Sentinel identification rate and the number of marked sentinel nodes was compared between groups. Concordance between two lymphatic markers was assessed using Cochrane's Kappa statistical method.


Study includes total of 204 patients. Sentinel node identification rate (95% CI) was 87.4% (+/- 6.5%) in group A, 94.1% (+/-8.7%) in B and 100% (+/- 2.6%) in group C. Median number of marked nodes was one node. There were more hot nodes in group C than in groups A and B (P = 0.002). In group C, concordance index between blue dye and radioactive tracer was relatively weak (kappa=0.049, 95% CI 0-0.244).


Radioactive tracer can be used as single lymphatic marker, however, for best results dual marking is recommended. Methylene blue dye and radioactive Technecium colloid can be considered as complimentary when used simultenously. The use of blue dye as a single lymphatic marker is not recommended because of unacceptably low sentinel identification rate.

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All authors have declared no conflicts of interest.