Evaluation of Axilla With Sentinel Lymph Node Biopsy (Using Methylene-Blue) and Reverse Axillary Mapping (Using Fluorescein) to Validate Optimum and Safe Axillary Dissection in Breast Cancer

Introduction Sentinel lymph node biopsy (SLNB) has replaced routine axillary dissection (ALND) in node-negative axillae. In cases where the axilla needs to be dissected, one must dissect below uppermost intercostobrachial nerve (ICBN) avoid damaging arm lymphatics. Methods One milliliter of methylene blue dye was injected around areola. Fluorescein (1 ml) into upper arm. After SLNB and ALND, visualized under light. The location fluorescent lymphatics mapped with respect ICBN. Results identification rate sentinel nodes 100%. Arm were above ICBN 86.7%. false negative 13%, sensitivity specificity 87% 100%, respectively. Conclusions using single-dye technique results comparable dual agent studies that utilize radioactive colloid. could define superior limit dissection.