A comparison of methylene blue and lymphazurin in breast cancer sentinel node mapping

Blessing, Walter D; Stolier, Alan; Teng, Steven; Bolton, John S.; Fuhrman, George M.

doi:10.1016/s0002-9610(02)00948-0

Cited by 116 publications

(86 citation statements)

References 20 publications

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“…one study demonstrate an identification rate of 98.7% in 329 early breast cancer patients 65 . Other studies have shown similar identification rates [73][74][75] . The other advantages of using Methylene blue include its lower cost 74 and wider availability.…”

Section: Avoidance Of Risk By Using Methylene Blue or Corticosteroid supporting

confidence: 65%

Sentinel lymph node biopsy in early breast cancer surgery – Working with the risks of vital blue dye to reap the benefits

White

Harvey

Griffith

et al. 2011

European Journal of Surgical Oncology (EJSO)

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Section: Avoidance Of Risk By Using Methylene Blue or Corticosteroid supporting

confidence: 65%

Sentinel lymph node biopsy in early breast cancer surgery – Working with the risks of vital blue dye to reap the benefits

White

Harvey

Griffith

et al. 2011

European Journal of Surgical Oncology (EJSO)

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“…isosulphan blue dye (Lymphazurin 1 %) and methylene blue, or technetium 99m tagged with sulphur colloid or antimony, in sub-areolar, intradermal, peri-tumoral or intra-tumoral location of the breast. In Europe, many centres use technetium 99m tagged with colloidal albumin [4][5][6][7]. Many authors have demonstrated that the combination of radioisotope and a blue dye for lymphatic mapping improves the sentinel lymph node identification probability compared to the use of a single tracer [8].…”

Section: Methods Of Sentinel Lymph Node Biopsymentioning

confidence: 99%

What Is a False Negative Sentinel Node Biopsy: Definition, Reasons and Ways to Minimize It?

2016

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Sentinel node biopsy helps in assessing the involvement of axillary lymph node without the morbidity of full axillary lymph node dissection, namely arm and shoulder pain, paraesthesia and lymphoedema. The various methods described in the literature identify the sentinel lymph nodes in approximately 96 % of cases and associated with a false negativity rate of 5 to 10 %. A false negative sentinel node is defined as the proportion of cases in whom sentinel node biopsy is reported as negative, but the rest of axillary lymph node(s) harbours cancer cells. The possible causes of a false negative sentinel lymph node may be because of blocked lymphatics either by cancer cells or following fibrosis of previous surgery/radiotherapy, and an alternative pathway opens draining the blue dye or isotope to another uninvolved node. The other reasons may be two lymphatic pathways for a tumour area, the one opening to a superficial node and the other in deep nodes. Sometimes, lymphatics do not relay into a node but traverse it going to a higher node. In some patients, the microscopic focus of metastasis inside a lymph node is so small-micrometastasis (i.e. between 0.2 and 2 mm) or isolated tumour cells (i.e. less than 0.2 mm) that is missed by the pathologist. The purpose of this review is to clear some fears lurking in the mind of most surgeons about the false negative sentinel lymph node (FNSLN).

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“…11,13 Although methylene blue is more readily available and considerably less expensive than the others, some authors claim that it diffuses more rapidly in peripheral tissues, staining a larger portion of the breast with the blue dye and, to a certain extent, hampering the procedure. [14][15][16] Other authors have reported similar accuracy and sentinel lymph node detection rates with methylene blue and with patent blue. 13,17 There appears to be a lower risk of anaphylaxis with methylene blue compared to the other dyes.…”

Section: Introductionmentioning

confidence: 90%

“…In fact, the few published studies available comparing the two methods failed to show any difference between them. 15,20 Considering a confidence level of 5% and a power of the test of 80%, a total of 116 patients would be required, divided into the two groups. To compensate for any possible losses, 142 patients were enrolled to the study.…”

Section: Methodsmentioning

confidence: 99%

A prospective randomized trial comparing patent blue and methylene blue for the detection of the sentinel lymph node in breast cancer patients

Paulinelli

Freitas‐Junior

Rahal

et al. 2017

Rev. Assoc. Med. Bras.

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Introduction:Methylene blue is more widely available and less expensive than patent blue, with an apparently lower risk of anaphylaxis. Objective: The two dyes were compared regarding detection of the sentinel lymph node (SLN). Method: A prospective, randomized trial involved 142 patients with invasive breast carcinoma. Sixty-nine (49.3%) assigned to patent blue (group A) and 71 (50.70%) to methylene blue (group B). Thirty-five patients (25.0%) were clinical stage III or IV; 55 (38.7%) had axillary lymph nodes affected; and 69 (49.3%) underwent neoadjuvant chemotherapy. Two patients were excluded because the dye type was not recorded. Results: Patients and tumor characteristics were similar in both groups. SLNs were identified in 47 women (68.1%) in group A and 43 (60.6%) in group B (p=0.35). SLNs were affected in 22 cases (51.2%) in group A and 21 (48.8%) in group B (p=0.62). The SLN was the only node affected in 12 cases (54.5%) in group A and six (33.3%) in group B (p=0.18). The time and degree of difficulty involved in identifying the SLN were similar in both groups. There were no complications or allergies. Conclusion: Methylene blue performed as well as patent blue in identifying the SLN in breast cancer patients.

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A comparison of methylene blue and lymphazurin in breast cancer sentinel node mapping

Cited by 116 publications

References 20 publications

Sentinel lymph node biopsy in early breast cancer surgery – Working with the risks of vital blue dye to reap the benefits

Sentinel lymph node biopsy in early breast cancer surgery – Working with the risks of vital blue dye to reap the benefits

What Is a False Negative Sentinel Node Biopsy: Definition, Reasons and Ways to Minimize It?

A prospective randomized trial comparing patent blue and methylene blue for the detection of the sentinel lymph node in breast cancer patients

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