Safety and technical success of methylene blue dye for lymphatic mapping in breast cancer

Zakaria, Shaheen; Hoskin, Tanya L.; Degnim, Amy C.

doi:10.1016/j.amjsurg.2007.08.060

Cited by 81 publications

(73 citation statements)

References 31 publications

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“…In studies conducted in our country isosulphane blue was often preferred (9)(10)(11). In the literature, there are many studies showing that methylene blue can be used safely and with high success as an alternative to isosulphane blue (12)(13)(14)(15) Core biopsy is the gold standard in the diagnosis of breast cancer, although there are physicians who prefer excisional biopsy. Some of our patients were referred to our clinic with a diagnosis and we chose to include the patients in whom excisional biopsy was previously performed into the study.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Methylene Blue in Sentinel Lymph Node Biopsy for Early Breast Cancer

et al. 2014

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Objective: Sentinel lymph node biopsy is the recommended approach in the evaluation of axilla during breast cancer surgery. In this study, results of patients who underwent methylene blue sentinel lymph node biopsy were evaluated. Materials and Methods:The study included 32 female patients with T1 and T2 tumors. 5 ml of 1% methylene blue was injected into the peritumoral area or around the cavity. The axillary sentinel lymph node was found and removed, and then axillary dissection was performed. The sentinel lymph node and axillary dissection specimen were histopathologically examined and the results were compared. Results:The sentinel lymph node was found in 30 (94%) patients. Lymph node metastasis was not observed in 17 patients in both the sentinel lymph node and axilla. Two patients had metastasis in the axilla although this was not detected in sentinel lymph node. Eleven patients had metastasis both in the sentinel lymph node and in the axilla . The accuracy rate was 93%, and the false negativity rate was identified as 15%. Conclusion:Sentinel lymph node biopsy by methylene blue is a method that can be applied with high accuracy. Methylene blue can be considered as an alternative to isosulphane blue in sentinel lymph node biopsy.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Methylene Blue in Sentinel Lymph Node Biopsy for Early Breast Cancer

et al. 2014

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“…Azon PABC-esetekben, akik elutasítják a radiokolloid alkalmazását, a nyirokelvezetés feltérképezésére a szö-vetbarát kék festékek is segítséget adhatnának, ha ezekkel a szerekkel több tapasztalat állna rendelkezésre és nem volnának C tiltólistán [21,23,24].…”

Section: Metilénkék a Terhességi őRszemnyirokcsomó-biopsziábanunclassified

“…Az intraamnionalisan alkalmazott dózis 2,5 mg volt, ami súlyos teratogén hatással bírt az emésztőtraktus (intestinalis atresia) és a bőr fejlődésére [21]. Ismert hatás volt még a photoxicitás, a hyperbilirubinaemia, a haemolyticus anaemia és a lég-zési elégtelenség [21,23,24].…”

Section: Metilénkék a Terhességi őRszemnyirokcsomó-biopsziábanunclassified

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Sentinel lymph node biopsy in pregnancy-associated breast cancer

et al. 2013

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A terhességi emlőrák incidenciája növekszik. Klinikailag nyirokcsomó-negatív esetekben az őrszemnyirokcsomó-biopszia lenne az indikált minimál-invazív regionális staging eljárás. A nyirokelvezetés leképezéséhez szükséges radioizotóp, valamint kék festék teratogén hatásáról a múltban számos vélt és valós megállapítás vált általános érvényűvé, ami a közelmúltig az eljárás kontraindikációját képezte. Napjainkra az irodalomban az alacsony dózisú 99m Tc-jelölt humán albumin nanokolloid alkalmazásával sikeres beavatkozásokról számolnak be, a dozimetriamodellezések által igazolt, a magzatot érő elhanyagolható sugárexpozíció alapján. Az eredményeknek köszönhetően mára az őrszem-nyirokcsomó-biopszia terhességben biztonságosan és eredményesen végezhetőnek látszik, bár az axillaris lymphadenectomia általános érvényű kiváltására, biztos bizonyítékok hiányában, még nem képes. Az őrszemnyirokcsomó-biopszia lehetőségét korai emlőrákban szenvedő, klinikailag negatív axillával bíró kismamák számára fel kell ajánlani, és átfogó felvilágosítást követően a betegeket szükséges bevonni a döntésbe. Jelen közleményben a szerzők két terhesség során alacsony dózisú tracerrel sikeresen végzett őrszemnyirokcsomó-biopszia esetét mutatják be, és magyar nyelven elsőként tekintik át a téma szakirodalmát. Orv. Hetil., 2013, 154(50), 1991-1997.Tc-jelölt humán albumin Sentinel lymph node biopsy in pregnancy-associated breast cancerThe incidence of pregnancy-associated breast cancer is rising. Sentinel lymph node biopsy is the method of choice in clinically node negative cases as the indicated minimally invasive regional staging procedure. Some reports have linked radioisotope and blue dye required for lymphatic mapping to teratogenic effects, the idea of which has become a generalized statement and, until recently, contraindication for these agents was considered during pregnancy. Today, there are many published reports of successful interventions with low-dose 99m Tc-labeled human albumin nanocolloid, based on dosimetric modeling demonstrating a negligible radiation exposure of the fetus. These results contributed to the seemingly safe and successful use of sentinel lymph node biopsy during pregnancy, though generally it can not replace axillary lymphadenectomy in the absence of high-quality evidence. The possibility of sentinel lymph node biopsy should be offered to pregnancy-associated early breast cancer patients with clinically negative axilla, and patients should be involved in the decision making following extensive counselling. This paper presents the successful use of sentinel lymph node biopsy with low-dose tracer during two pregnancies (in the fi rst and third trimesters) and, for the fi rst time in Hungarian language, it offers a comprehensive literature review on this topic.

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“…We herein describe 2 different complications in 2 patients: 1) skin and parenchymal necrosis when MBD was injected subdermally and 2) Mycoplasma infection caused by contaminated MBD in breast reduction surgery. S e v e r a l p u b l i c a t i o n s a d v o c a t e t h e u s e o f s u bdermal MBD injections for SLN mapping without complications (1-3); however, several publications report complications ranging from blue staining of the skin and fat necrosis (4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Complications of Methylene Blue Dye in Breast Surgery: Case Reports and Review of the Literature

Reyes¹,

Noelck²,

Valentino³

et al. 2011

J. Cancer

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Introduction: Methylene blue dye has been used worldwide successfully with few complications in breast surgery. We present two different complications involving methylene blue: 1) skin and parenchymal necrosis when dye was injected in a subdermal fashion and 2) Mycoplasma infection caused by contaminated methylene blue in breast reduction surgery. Methods: We present two cases seen at the University of Arizona during 2008 and referred to a breast surgeon for management. We evaluated and managed complications of methylene blue dye injected by 2 referring surgeons for different indications. A review of the literature was performed. Results: The first case is a 67 year old female diagnosed with infiltrating ductal carcinoma o f the left breast for which she was treated by her initial surgeon with left segmental mastectomy and sentinel node biopsy. The operating surgeon injected methylene blue in a subareolar subdermal fashion (distant from the primary tumor); unfortunately the patient suffered skin and breast necrosis requiring multiple surgical debridements and finally achieving delayed primary closure. The second case is a 45 year old female with infiltrating lobular carcinoma with a history of Mycoplasma infection secondary to methylene blue injected for breast reduction surgery. She required multiple debridements and had granulomas masquerading as cancer on MRI that confounded her extent of disease. Conclusions: The use of methylene blue dye in breast surgery is not without risk. In both cases methylene blue was responsible for complications requiring surgical debridement for local wound problems. In each case severe necrosis and infection were present. Methylene blue may cause not only significant morbidity, but may also produce cosmetically unsatisfactory results.

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Safety and technical success of methylene blue dye for lymphatic mapping in breast cancer

Cited by 81 publications

References 31 publications

Efficacy of Methylene Blue in Sentinel Lymph Node Biopsy for Early Breast Cancer

Efficacy of Methylene Blue in Sentinel Lymph Node Biopsy for Early Breast Cancer

Sentinel lymph node biopsy in pregnancy-associated breast cancer

Complications of Methylene Blue Dye in Breast Surgery: Case Reports and Review of the Literature

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