Methylene blue dye, an accurate dye for sentinel lymph node identification in early breast cancer.
OBJECTIVE
The aim of this prospective study was to analyze the safety of methylene blue dye (MBD) and compare its efficacy with that of isotopic mapping for sentinel lymph node (SLN) identification in breast cancer.


METHODS
The SLN procedure, involving isotopic mapping and MBD (subareolar intraparenchymal injections of 2 mL, 10 mg/mL), was performed on 100 patients with early breast cancer.


RESULTS
The procedure was safe with a success rate of 99%; SLNs were, respectively, found in 65% by MBD, in 73% by lymphoscintigraphy and in 94% by gamma-probe. Out of 40 metastatic SLNs, 37 were "hot" and 32 stained. Digital examination allowed the detection of 2 additional metastatic LNs.


CONCLUSIONS
MBD is safe and combination mapping associated with digital examination is the superior method. Modification of the procedure, favouring injections of dilute MBD (4 mL, 1.25 mg/mL) increases MBD efficiency (90%) and maintains low rates of complications.
Unité de sénologie, 1 place de l'Hôpital, F-67091 Strasbourg Cedex, France. carole.mathelin@chru-strasbourg.fr
Carole
C
Mathelin
Sabrina
S
Croce
David
D
Brasse
Béatrice
B
Gairard
Mouslim
M
Gharbi
Norosoa
N
Andriamisandratsoa
Virgile
V
Bekaert
Ziad
Z
Francis
Jean-Louis
JL
Guyonnet
Daniel
D
Huss
Samuel
S
Salvador
Roland
R
Schaeffer
Daniel
D
Grucker
Cristi
C
Marin
Jean-Pierre
JP
Bellocq
D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002278:Carcinoma in Situ / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008751:Methylene Blue; D008875:Middle Aged; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013455:Sulfur; D013671:Technetium Tc 99m Sulfur Colloid
D019275:Radiopharmaceuticals; C512413:nanocis; C105539:rhenium sulfur colloid; D013671:Technetium Tc 99m Sulfur Colloid; D013455:Sulfur; D008751:Methylene Blue