The Study Of Methylene Blue Combined With Fluorescein Dye In Clinical N+ Breast Cancer Patients Who Turned N0 After NAC And Its Influencing Factors

Objectives: To investigate the accuracy and false-negative rate of sentinel lymph node biopsy in patients with clinically positive axillary lymph node after neoadjuvant chemotherapy and negative breast cancer using methylene blue combined with fluorescein dye as a tracer for sentinel lymph node biopsy.Whether the general information and pathological data of the patient have any influence on it.Methods: A total of 43 breast cancer patients with positive axillary lymph nodes who met the inclusion criteria at xx Breast Disease Clinic from September 2020 to January 2022 were collected.The basic case information and pathological data of patients were collected,and the detection rate,accuracy rate,false negative rate,sensitivity and negative sensitivity of sentinel lymph node biopsy were obtained through the evaluation criteria of sentinel lymph node biopsy.Univariate analysis was carried out to explore the potential influencing factors of sentinel lymph node biopsy and the related factors affecting the accuracy and false negative rate of sentinel lymph node biopsy.Results: According to the inclusion and exclusion criteria,a total of 43 patients who underwent sentinel lymph node biopsy were enrolled in this experiment,of which 0 were not detected,and 43 were successfully detected.The total number of sentinel lymph nodes biopsy was 131,with an average of 3.04.The true negative,true positive,and false negative were 16,24,and 3 cases,respectively.Referring to the evaluation criteria of SLNB technology,the detection rate of sentinel lymph node biopsy in this group of patients was 100%(43/43),the false negative rate was 11.11%(3/27),and the accuracy rate was 93.02%(40/43).),the sensitivity was 88.89%(24/27),and the negative sensitivity was 84.21%(16/19).Univariate analysis : In the accuracy of sentinel lymph node biopsy,the number of sentinel lymph nodes detected(P=0.013)was related to it,but the molecular typing of breast cancer,tumor size before and after neoadjuvant chemotherapy,Ki67value-added index,evaluation of efficacy after neoadjuvant chemotherapy,menstrual status,age,N stages before neoadjuvant chemotherapy,and location of primary tumor were not related to it;In the false negative rate of sentinel lymph node biopsy,the number of sentinel lymph nodes detected(P = 0.041)was related to it,but the other factors mentioned above were not related to it.Conclusions: 1.In patients with positive axillary lymph nodes and negative breast cancer after neoadjuvant chemotherapy,the use of methylene blue combined with indocyanine green as a tracer for sentinel lymph node biopsy can achieve higher accuracy and lower false positives.Negative rate,and the two tracers are economical and convenient,and can be used as tracers for sentinel lymph node biopsy in breast cancer patients under this condition.2.The accuracy and false negative rate of sentinel lymph node biopsy in breast cancer are closely related to the number of detected sentinel lymph nodes,but not related to other factors.