Assessment of Efficacy of Sentinel Lymph Node Biopsy in Breast Cancer Patients after Receiving Neoadjuvant Chemotherapy Using Patent Blue Dye

Background: Neoadjuvant chemotherapy (NACT) is a treatment option for patients with resectable breast malignancies. It aims to reduce the tumor mass and its clinical stage. It also may boost the likelihood of breast-conserving operation. It is crucial to look at the viability and dependability of sentinel lymph node biopsy (SLNB) as a substitute for the dissection of axillary lymph nodes in patients with breast cancer following NACT. In order to detect the skip lesion phenomenon that occurs with SLNB, the patent blue dye was used in this study to assess the the effectiveness, sensitivity, and specificity of SLN sampling in patients with breast cancer following NACT.Methods: This prospective analysis included 55 female breast cancer patients who had received NACT including:- Triple hormonal receptors negative patients with tumor ≥T1c ,HER2 positive patients with tumor ≥T2 and Luminal breast cancer patients for whom NACT was indicated (large mass relative to breast size).all of them did not have positive lymph nodes after NACT, and none of them had ever undergone breast surgery.Results: The identification rate of SLN is 50/55=90.9%, When used to predict breast cancer after NACT, SLNB's sensitivity was 88.9%, and specificity was one hundred percent. false negative ratio, accuracy, positive predictive value and negative predictive value were 11.1%, 96%, 100%, and 94.1% respectively. before NACT, 9.1% of patients were in stage I, 54.5% in stage II, and 36.4% in stage III. 18.8% had progesterone receptors, 23.6 % had estrogen receptors, and 36.4% had human epidermal growth factor receptors. Sixty-nine percent had wide local excision, and thirty one percent had a modified radical mastectomy. 3.6% had one SLN, 18.2% had two, 50.9% had three, and 18.2% had four. The mean SLN was 2.7 (±1.1 SD).Conclusions: SLNB using the patent blue dye technique for assessing axillary nodal status in breast cancer patients following NACT, is a reliable method with acceptable rates especially in centers which don’t have an access to radioactive facility.