Methylene Blue Dye as an Alternative to Isosulfan Blue Dye for Sentinel Lymph Node Localization
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Background: Our study describes the use of methylene blue dye as an alternative to isosulfan blue dye to identify the sentinel lymph node (SLN).
Methods: A retrospective analysis was performed of 112 breast cancer patients (113 axillae) who underwent SLN biopsy (SLNB) with methylene blue dye and 99mTc-labeled sulfur colloid for SLN identification. All SLNs were submitted for intraoperative frozen section analysis, hematoxylin and eosin stain, and immunohistochemical evaluation. Patients with a pathologically negative SLN did not undergo further axillary lymph node dissection.
Results: Of 112 patients who underwent SLNB, the SLN was identified in 107 (95.5%); 104 (92.8%) were identified by methylene blue dye. In a subset of 99 patients with recorded isotope status in relation to blue nodes, concordant identification with both dye and isotope was observed in 94 (94.9%). Of patients with identified SLNs, 32 (29.9%) of 107 contained metastatic disease, with 31 (96.9%) of 32 identified by methylene blue dye. The SLN was the only positive node in 18 (60.0%) of 30 patients.
Conclusions: SLNB with methylene blue dye is an effective alternative to isosulfan blue dye for accurately identifying SLNs in breast cancer patients.
- Cascinelli N, Belli F, Santinami M, et al. Sentinel lymph node biopsy in cutaneous melanoma: the WHO Melanoma Program experience. Ann Surg Oncol 2000; 7: 469–74.
- Medina-Franco H, Beenken SW, Heslin MJ, Urist MM. Sentinel node biopsy for cutaneous melanoma in the head and neck. Ann Surg Oncol 2001; 8: 716–9.
- Link EM, Costa DC, Lane D, Blower PJ, Spittle MF. Radioiodinated methylene blue for diagnosing early melanoma metastases. Lancet 1996; 348: 753.
- Landra M, Acchiardi F, Pugno F, Forte G, Granetto C, Camuzzini GF. Sentinel node mapping for malignant melanoma. Tumori 2000; 86: 354–5.
- Fukui Y, Yamakawa T, Taniki T, Numoto S, Miki H, Monden Y. Sentinel lymph node biopsy in patients with papillary thyroid carcinoma. Cancer 2001; 92: 2868–74.
- Cserni G. Metastases in axillary sentinel lymph nodes in breast cancer as detected by intensive histopathological work up. J Clin Pathol 1999; 52: 922–4. CrossRef
- Weaver DL, Krag DN, Ashikaga T, et al. Pathologic analysis of sentinel and nonsentinel lymph nodes in breast carcinoma: a multicenter study. Cancer 2000; 88: 1099–107.
- Simmons RM, Smith SMR, Osborne MP. Methylene blue as an alternative to isosulfan blue dye for sentinel lymph node localization. Breast J 2001; 7: 181–3.
- Giuliano AE, Kirgan DM, Guenther JM, Morton DL. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg 1994; 220: 391–401.
- O’Hea BJ, Hill AD, El-Shirbiny AM, et al. Sentinel lymph node biopsy in breast cancer: initial experience at Memorial Sloan-Kettering Cancer Center. J Am Cancer Soc 1998; 186: 423–7.
- Bass SS, Cox CE, Ku NN, Berman C, Reintgen DS. The role of sentinel node biopsy in breast cancer. J Am Cancer Soc 1999; 189: 183–94.
- Giuliano AE, Jones RC, Brennan M, Statman R. Sentinel lymphadenectomy in breast cancer. J Clin Oncol 1997; 15: 2345–50.
- Derossis AM, Fey J, Yeung H, et al. A trend analysis of the relative value of blue dye and isotope localization in 2,000 consecutive cases of sentinel node biopsy for breast cancer. J Am Coll Surg 2001; 93: 473–8.
- McMasters KM, Tuttle TM, Carlson DJ, et al. Sentinel lymph node biopsy for breast cancer: a suitable alternative to routine axillary dissection in multi-institutional practice when optimal technique is used. J Clin Oncol 2000; 18: 2560–6.
- Tafra LC, Lannin DR, Swanson MS, et al. Multicenter trial of sentinel node biopsy for breast cancer using both technetium sulfur colloid and isosulfan blue dye. Ann Surg 2001; 233: 51–9.
- Tanis PJ, Deurloo EE, Valdes Olmos RA, et al. Single intralesional tracer dose for radio-guided excision of clinically occult breast cancer and sentinel node. Ann Surg Oncol 2001; 8: 850–5.
- Linehan DC, Hill ADK, Akhurst T, et al. Intradermal radiocolloid and intraparenchymal blue dye injection optimize sentinel node identification in breast cancer patients. Ann Surg Oncol 1999; 6: 450–4.
- Albertini JJ, Lyman GH, Cox C, et al. Lymphatic mapping and sentinel node biopsy in the patient with breast cancer. JAMA 1996; 276: 1818–22. CrossRef
- Koller M, Barsuk D, Zippel D, Engelberg S, Ben-Ari G, Papa MZ. Sentinel lymph node involvement: a predictor for axillary node status with breast cancer—has the time come? Eur J Surg Oncol 1998; 24: 166–8.
- Borgstein PJ, Pijper R, Comans EF, van Diest PJ, Boom RP, Meijer S. Sentinel lymph node biopsy in breast cancer: guidelines and pitfalls of lymphoscintigraphy and gamma probe detection. J Am Cancer Soc 1998; 186: 275–83.
- Hsueh EC, Turner RR, Glass EC, Brenner RJ, Brennan M, Giuliano AE. Sentinel node biopsy in breast cancer. J Am Cancer Soc 1999; 189: 207–13.
- Gann PH, Colilla SA, Gapstur SM, et al. Factors associated with axillary lymph node metastasis from breast cancer: descriptive and predictive analyses. Cancer 1999; 86: 1511–9.
- Chao C, Wong SL, Ackermann D, et al. Utility of intraoperative frozen section analysis of sentinel lymph nodes in breast cancer. Am J Surg 2001; 182: 609–15.
- Albo D, Wayne JD, Hunt KK, et al. Anaphylactic reactions to isosulfan blue dye during sentinel lymph node biopsy for breast cancer. Am J Surg 2001; 182: 393–8.
- Cimmino VM, Brown AC, Szocik JF, et al. Allergic reactions to isosulfan blue during sentinel node biopsy—a common event. Surgery 2001; 130: 439–42.
- Longnecker SM, Guzzardo MM, Van Voris LP. Life-threatening anaphylaxis following subcutaneous administration of isosulfan blue 1%. Clin Pharm 1995; 4: 219–21.
- Leong SP, Donegan E, Heffernon W, et al. Adverse reactions to isosulfan blue during selective sentinel lymph node dissection in melanoma. Ann Surg Oncol 2000; 7: 361–6.
- Laurie SA, Khan DA, Gruchalla RS, Peters G. Anaphylaxis to isosulfan blue. Ann Allergy Asthma Immunol 2002; 88: 64–6. CrossRef
- Methylene Blue Dye as an Alternative to Isosulfan Blue Dye for Sentinel Lymph Node Localization
Annals of Surgical Oncology
Volume 10, Issue 3 , pp 242-247
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Methylene blue
- Sentinel node
- Isosulfan blue
- Breast cancer
- Sentinel lymph node biopsy
- Industry Sectors
- Author Affiliations
- 1. Department of Surgery, New York Presbyterian Hospital, New York, New York
- 4. 425 East 61st Street, 8th Floor, New York, NY, 10021
- 2. Weill Cornell Breast Center, New York Presbyterian Hospital, New York, New York
- 3. Department of Public Health, the Weill Cornell Medical College, New York, New York