title: Pharmacokinetics of methylene blue dye for lymphatic mapping in breast cancer-implications for use in pregnancy.
abstract: BACKGROUND
  although blue dye is routinely used for lymphatic mapping, it is not used for lymphatic mapping in pregnancy-associated breast cancer, because of concern of fetal risk.
  
  
  METHODS
  to investigate the safety of blue dye for lymphatic mapping in pregnant women, the pharmacokinetics of methylene blue dye were examined in 10 nonpregnant women, and the results were extrapolated to estimate maximal fetal exposure to the dye.
  
  
  RESULTS
  plasma and urine measurements indicated that the dye quickly distributed from the breast injection site to the circulation, with 32% of the total dose excreted in urine within 48 hours. Combined with existing data on organ distribution of methylene blue, the estimated maximal dose to the fetus is 0.25 mg (5% of the administered dose), likely further reduced by other physiologic factors related to pregnancy.
  
  
  CONCLUSIONS
  the analysis suggests that methylene blue dye can be used for lymphatic mapping in pregnancy-associated breast cancer with minimal fetal risk.
authors.affiliation: Department of Internal Medicine, Breast Diagnostic Clinic, Mayo Clinic and Mayo Foundation, Rochester, MN, USA.
authors.forename: Sandhya
authors.initials: S
authors.lastname: Pruthi
authors.forename: Caroline
authors.initials: C
authors.lastname: Haakenson
authors.forename: Brian C
authors.initials: BC
authors.lastname: Brost
authors.forename: Kanesha
authors.initials: K
authors.lastname: Bryant
authors.forename: Joel M
authors.initials: JM
authors.lastname: Reid
authors.forename: Ravinder
authors.initials: R
authors.lastname: Singh
authors.forename: Brian
authors.initials: B
authors.lastname: Netzel
authors.forename: Judy C
authors.initials: JC
authors.lastname: Boughey
authors.forename: Amy C
authors.initials: AC
authors.lastname: Degnim
mesh_terms: D000328:Adult; D000368:Aged; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000473:pathology; D004396:Coloring Agents / Q000009:adverse effects / Q000493:pharmacokinetics*; D005260:Female; D006801:Humans; D008751:Methylene Blue / Q000009:adverse effects / Q000493:pharmacokinetics*; D008875:Middle Aged; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000473:pathology*; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced; D049188:Prenatal Injuries / Q000139:chemically induced*; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*
chemical_list: D004396:Coloring Agents; D008751:Methylene Blue