ObjectiveTo investigate the clinical application effects of endoscopic sentinel lymph node biopsy (ESLNB) in early breast cancer. MethodsThe clinical data of 132 female patients in early breast cancer undergoing sentinel lymph node biopsy (SLNB) were retrospectively analyzed, among which 46 cases underwent biopsy by endoscopy (endoscopy group), whereas 86 cases underwent open biopsy (open group). The double staining method (methylene blue + carbon nanoparticles) and single staining method (methylene blue) were employed to conduct SLNB in both groups, respectively. The detection condition of lymph nodes and various complications after biopsy were analyzed, the detection results using different staining methods, intrabiopsy blood loss volume, biopsy duration, partial skin irritation, shoulder joint function after biopsy, and beauty satisfaction were compared between the two groups. ResultsThere were no statistically significant differences in the detection and positive rate of lymph nodes between the two groups (all P＞0.05). The double staining method in the open group interpreted the sensitivity, specificity, positive predictive value and negative predictive value in 83.87% (26/31), 96.97% (32/33), 96.30% (26/27), and 86.49% (32/37), respectively, whereas the indicators mentioned above in the single staining method in 77.78% (7/9), 84.62% (11/13), 77.78% (7/9), and 84.62% (11/13), respectively. The double staining method in the endoscopy group presented the sensitivity, specificity, positive predictive value and negative predictive value in 94.12% (16/17), 100.00% (18/18), 100.00% (16/16), and 94.74%(18/19), respectively, while the indicators mentioned above in the single staining method in 50.00% (1/2), 88.89% (8/9), 50.00% (1/2), and 88.89% (8/9), respectively. Compared with the open group, the endoscopy group yielded less intrabiopsy blood loss volume, whereas longer biopsy duration (all P＜0.05). The incidence of skin irritation after biopsy in the double staining method was 5.05% (5/99), which was significantly lower than that in the single staining method ［54.55% (18/33), （P＜0.05)］. The incidence of complications after biopsy was significantly lower in the endoscopy group than in the open group (P＜0.05). After 3 months of biopsy, the endoscopy group yielded a superior shoulder joint function, and a higher beauty satisfaction as compared with the open group (all P＜0.05). ConclusionEmploying endoscopy to conduct SLNB in early breast cancer has longer biopsy duration than employing open SLNB; however, there is no prominent difference of safety between the two methods. Endoscopy combined with breast-conserving surgery can preserve the appearance of the breast, and also maintain armpit beauty; meanwhile, endoscopy can effectively reduce the adverse consequences such as scar contracture and poor recovery of shoulder function caused by open SLNB. The double staining method can not only enhance the image develop of lymph vessels, but also reduce the stimulation to partial tissues, so as to significantly decrease the false-negative rate of SLNB without significantly increasing the number of surgical steps, which is worthy of clinical promotion and application.

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