Sentinel Node Biopsy Using Lymphazurin

  • Helen Mabry
  • Armando E. Giuliano


Sentinel node biopsy (SNB) is a less invasive alternative to axillary lymph node dissection for staging the axilla in early breast cancer. SNB can be performed with Technetium labeled radiocolloid alone, in combination with a blue dye, or with a blue dye alone. Excellent results can be achieved with experience using any one of these techniques. This chapter will provide a summary of blue dye techniques.


Sentinel Node Sentinel Node Biopsy Methylene Blue Axillary Lymph Node Dissection False Negative Rate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Giuliano AE, Kirgan DM, Guenther JM, et al. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg. 1994;220:391–401.PubMedCrossRefGoogle Scholar
  2. 2.
    Morton D, Wen D-R, Wong J, et al. Technical details of introperative lymphatic mapping for early stage melanoma. Arch Surg. 1992;127:392–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Albertini JJ, Lyman GH, Cox C, et al. Lymphatic mapping and sentinel node biopsy in the patient with breast cancer. JAMA. 1996;276(22):1818–22.PubMedCrossRefGoogle Scholar
  4. 4.
    Borgstein PJ, Meijer S, Pijpers R. Intradermal blue dye to identify the sentinel lymph node in breast cancer. Lancet. 1997;349:1668–9.PubMedCrossRefGoogle Scholar
  5. 5.
    Kern KA. Sentinel lymph node mapping in breast cancer using subareolar injection of blue dye. J Am Coll Surg. 1999;198:539–45.CrossRefGoogle Scholar
  6. 6.
    Kern KA. Concordance and validation study of sentinel node biopsy for breast cancer using subareolar injection of blue dye and technetium 99m sulfur colloid. J Am Coll Surg. 2002;195(4):467–75.PubMedCrossRefGoogle Scholar
  7. 7.
    Chagpar A, Martin RC, Chao C, et al. Validation of subareolar and peritumoral injection techniques for breast sentinel lymph node biopsy. Arch Surg. 2004;139:614–20.PubMedCrossRefGoogle Scholar
  8. 8.
    Gray J. The relation of the lymphatic vessels to the spread of cancer. Br J Cancer. 1939;26:462–95.Google Scholar
  9. 9.
    Degnim AC, Oh K, Cimmino VM, et al. Is blue dye indicated for sentinel lymph node biopsy in breast cancer patients with a positive lymphoscintigram? Ann Surg Oncol. 2005;12(9):712–7.PubMedCrossRefGoogle Scholar
  10. 10.
    Lucci Jr A, Keleman PR, Miller III C, et al. National practice patterns of sentinel lymph node dissection for breast carcinoma [comment]. J Am Coll Surg. 2001;192:453–8.PubMedCrossRefGoogle Scholar
  11. 2010.
    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;193:473–8.PubMedCrossRefGoogle Scholar
  12. 12.
    Morrow M, Rademaker AW, Bethke KP, et al. Learning sentinel node biopsy: results of a prospective randomized trial of two techniques. Surgery. 1999;126:714–20.PubMedCrossRefGoogle Scholar
  13. 13.
    Cox CE, Salud CJ, Cantor A, et al. Learning curves for breast cancer sentinel lymph node mapping based on surgical volume analysis. J Am Coll Surg. 2001;193:593–600.PubMedCrossRefGoogle Scholar
  14. 14.
    Thevarajah S, Huston TL, Simmons RM. A comparison of the adverse reactions associated with isosulfan blue versus methylene blue dye in sentinel lymph node biopsy for breast cancer. Am J Surg. 2005;189(2):236–9.PubMedCrossRefGoogle Scholar
  15. 15.
    Eldrageely K, Vargas MP, Khalkhali I, et al. Sentinel lymph node mapping of breast cancer: a case-control study of methylene blue tracer to isosulfan blue. Am Surg. 2004;70(10):872–5.PubMedGoogle Scholar
  16. 16.
    Stradling B, Aranha G, Gabram S. Adverse skin lesions after methylene blue injections for sentinel lymph node localization. Am J Surg. 2002;184(4):350–2.PubMedCrossRefGoogle Scholar
  17. 17.
    Singh-Ranger G, Mokbel K. Capsular contraction following immediate reconstructive surgery for breast cancer – an association with methylene blue dye. Int Semin Surg Oncol. 2004;2010(1):1–3.CrossRefGoogle Scholar
  18. 18.
    Govaert GA, Oostenbroek RJ, Plaisier PW. Prolonged skin staining after intradermal use of patent blue in sentinel lymph node biopsy for breast cancer. Eur J Surg Oncol. 2005;31(4):373–5.PubMedCrossRefGoogle Scholar
  19. 19.
    Varghese P, Mostafa A, Abdel-Rahman AT, et al. Methylene blue dye versus combined dye-radioactive tracer technique for sentinel lymph node localization in early breast cancer. Eur J Surg Oncol. 2007;33(2):147–52.PubMedCrossRefGoogle Scholar
  20. 20.
    Wilke LG et al. Surgical complications associated with sentinel lymph node biopsy: results from a prospective International Cooperative Group Trial. Ann Surg Oncol. 2006;13:491–500.PubMedCrossRefGoogle Scholar
  21. 21.
    Raut CP, Daley D, Hunt K, et al. Anaphylactoid reactions to isosulfan blue dye during breast cancer lymphatic mapping in patients given preoperative prophylaxis. J Clin Oncol. 2004;22(3):567–8.PubMedCrossRefGoogle Scholar

Copyright information

© Springer New York 2010

Authors and Affiliations

  1. 1.John Wayne Cancer InstituteSaint John’s Health CenterSanta MonicaUSA

Personalised recommendations