# The value of nanocarbon contrast methylene blue based on dye-based tracer technology in sentinel lymph node biopsy for breast cancer: a systematic review and meta-analysis

## TL;DR

This study compares nanocarbon and methylene blue as tracers in sentinel lymph node biopsies for breast cancer, finding nanocarbon more effective.

## Contribution

A systematic review and meta-analysis showing nanocarbon outperforms methylene blue in sentinel lymph node detection for breast cancer.

## Key findings

- Nanocarbon showed higher sensitivity (0.93) and specificity (0.98) compared to methylene blue (0.89 and 0.94).
- The AUC for nanocarbon (0.9827) was higher than methylene blue (0.9495), indicating better diagnostic accuracy.
- Nanocarbon is recommended as a first-line tracer for sentinel lymph node biopsies in breast cancer patients.

## Abstract

The purpose of this study was to compare the diagnostic value of nanocarbon suspensions and methylene blue injections in sentinel lymph node biopsies of patients with breast cancer based on the dye method.

A systematic search of the PubMed, Embase, Cochrane Library (Central) and Web of Science (SCI Expanded) databases was performed to determine the diagnostic value of carbon nanoparticles in Chinese databases (China National Knowledge Infrastructure (CNKI), VIP, Wanfang, Chinese Biomedical Literature Database (CBM)) for identifying methylene blue in sentinel lymph node biopsies of patients with breast cancer. The QUADAS2 quality evaluation tool of Review Manager 5.4 was used to evaluate the quality of the included studies. Meta-Disc 1.4 software was used to calculate the extracted valid data and perform a heterogeneity test. STATA 14.0 software was selected to conduct a sensitivity analysis, and Deek’s publication bias test was used for the included studies.

In 17 articles, the binding sensitivity of nanocarbons was 0.93 (0.90–0.95), the binding specificity was 0.98 (0.97–0.99), the binding sensitivity of methylene blue was 0.89 (0.85–0.92), and the binding specificity was 0.94 (0.92–0.95). The AUC value of the nanocarbon SROC was 0.9827 (SE = 0.0062), and the AUC value of methylene blue was 0.9495 (SE = 0.0139).

Nanocarbon versus methylene blue is a more satisfactory dye tracer for sentinel lymph node biopsy in breast cancer patients and should be considered a first-line diagnostic agent.