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

Abstract

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.

New techniques for sentinel node biopsy in breast cancer

“…Another advantage of MB is the possibility to be used during pregnancy (23). In a recent prospective randomized trial MB performed as well as patent blue in identifying SLN in BC (24). MB has so become a standard widely used in USA.…”

Use of methylene blue for the detection of sentinel lymph node in breast cancer: a systematic review and meta-analysis

“…No complications or allergies reported. In a study by Paulinelli et al 35 , in the patent blue group, the rate of sentinel lymph node detection was 68.1% and in the methylene blue group, the rate of SLN detection was 60.6%.…”

“…In the study performed by Paulinelli et al, the patients and tumour characteristics were the same in both patient blue and MBD group. 35 About 142 patients were considered for this study. Sentinel lymph nodes were found in 47 patients accounting for 68.1% in PBD group and 43 patients accounting for 60.6% in MBD group with p = 0.35.…”

“…The researchers Paulinelli et al, compare three dyes, methylene blue, patent blue, and isosulphan blue. 35 They state that while methylene blue is cheaper, patent blue and isosulphan blue are costlier than MBD. .…”

Molecular fluorescence‐guided surgery of peritoneal carcinomatosis of colorectal origin: A narrative review

“…Many non‐targeted fluorescent probes have already been used in humans to enhance contrast during surgery in a variety of different indications, such as for example fluorescein for retinal fluorescein angiography, indocyanine green (ICG) for liver perfusion and lymph node detection, or methylene blue for sentinel lymph node detection in breast cancer patients …”