Sentinel lymph node mapping in breast cancer using subareolar injection of blue dye

Kern, Kenneth A.

doi:10.1016/s1072-7515(99)00200-8

Cited by 200 publications

(105 citation statements)

References 29 publications

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“…It became the theoretical basis for the subareolar injection of dye and/or isotope for lymphatic mapping as part of the SN biopsy for breast cancer (Kimberg, 1999;Kern, 1999). On the other hand, the individual lymphatic flow is not identical in each living patient studies of SN biopsy.…”

Section: Lymph Flow From Tumor To Sentinel Node (Yamashita 2008)mentioning

confidence: 99%

3D-CT Mammary Lymphography Facilitate the Endoscopic Sentinel Node Biopsy

Yamashita¹,

Haga²,

Shimizu³

2012

Computed Tomography - Clinical Applications

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Section: Lymph Flow From Tumor To Sentinel Node (Yamashita 2008)mentioning

confidence: 99%

3D-CT Mammary Lymphography Facilitate the Endoscopic Sentinel Node Biopsy

Yamashita¹,

Haga²,

Shimizu³

2012

Computed Tomography - Clinical Applications

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“…Intradermal, periareolar or subareolar sites have also been described (18,19). There are a limited number of studies indicating high success rates of identifying SLNs using subareolar injection of blue dye (20)(21)(22). Rodier et al (23), using both blue dye and radiolabelled isotope, found that using periareolar injection was equivalent to using peritumoral injection in identifying SLN.…”

Section: Pathological Considerationsmentioning

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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“…In a study by Nwriaku et al [18], using both blue dye and radiotracer, 119 women with breast carcinoma who underwent SLN and ALND, the SLN identification rate was 81% with one FN in a patient with axillary disease (FN rate of 4%). Mertz et al [42] analysed the relevance of the sub-areolar injection for SLN detection in multiple foci breast cancer, comparing 79 breast cancer patients who underwent 99m Tc filtered sulphur colloid sub-areolar injection (group I) with 32 patients who underwent peritumoural injection (group II). SLN was detected in 97.9% and 96.9% of the cases, respectively.…”

Section: Research Articlementioning

confidence: 99%

Sentinel lymph node biopsy: technique validation at the Setúbal

Ferreira¹,

Baía²,

Almeida³

et al. 2009

ecancer

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Aims: To evaluate the accuracy of sentinel lymph node biopsy in breast cancer patients at this institution, using combined technetium99m ( 99m Tc) sulphur colloid and patent blue vital dye. Methods:From March 2007 to July 2008, 50 patients with a tumour of less than 3 cm and with clinically negative axillary lymph nodes underwent sentinel lymph node biopsy (SLNB), followed by axillary lymph node dissection (ALND). Sub-areolar 99m Tc sulphur colloid injection was performed the day before surgery, and patent blue vital dye was also injected sub-areolarly at least 5 minutes before surgery. Sentinel lymph node was identified during the surgical procedure, using a gamma probe and direct vision. All sentinel nodes underwent frozen section analysis. Later haematoxylin and eosin staining and immunohistochemical analysis were performed. Finally, SLNB was compared with standard ALND for its ability to accurately reflect the final pathological status of the axillary nodes. Results:The sentinel lymph node (SLN) was identified in 48 of 50 patients (96%). The number of sentinel lymph nodes ranged from one to four (mean 1.48) and non-sentinel nodes ranged from seven to 27 (mean 14.33). Of the 48 patients with successfully identified SLNs, 29.17% (14/48) were histologically positive. Sensivity of the SLN to predict axilla was 93.75%; accuracy was 97.96%. The SLN was falsely negative in one patient-6.25% (1/16). Conclusions:The SLNB represents a major advance in the surgical treatment of breast cancer as a minimally invasive procedure predicting the axillary lymph node status. This validation study demonstrates the accuracy of the SLNB and its reasonable false negative rate when performed in our institute. It can now be used as the standard method of staging in patients with early breast cancer at this institution.

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Sentinel lymph node mapping in breast cancer using subareolar injection of blue dye

Cited by 200 publications

References 29 publications

3D-CT Mammary Lymphography Facilitate the Endoscopic Sentinel Node Biopsy

3D-CT Mammary Lymphography Facilitate the Endoscopic Sentinel Node Biopsy

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

Sentinel lymph node biopsy: technique validation at the Setúbal

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