Aim: to determine the role of targeted four node sampling (FNS) in axillary mapping in operable breast cancer. Methods: The present analytical hospital based study was conducted among histopathologically and cytologically confirmed patients of operable breast cancer admitted to inpatient department of General Surgery, Sri Krishna Medical College and Hospital, Muzaffarpur, India July 2019 to February 2020. A total of 30 patients, node negative operable cases of carcinoma breast after 3 cycles of neoadjuvant chemotherapy, were enrolled. Lymph node mapping was done by injecting 3 - 5 ml of methylene blue dye, just before surgery. Results: The sensitivity, specificity, positive predictive value and negative predictive value of 83.12%, 90.27%, 72.31% and 94.25% respectively for four node sampling of axilla, among operable breast cancer patients having node negative axilla. Conclusions: Targeted four node sampling using methylene blue dye can be considered as an alternative method for sentinel lymph node. Further study should be conducted to establish it as a reliable method for axillary lymph node staging.
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