title: Occurrence of prolonged injection site mass with methylene blue but not isosulfan blue after the sentinel node procedure.
abstract: OBJECTIVE
  Methylene blue and isosulfan blue perform similarly in the sentinel node procedure.
  
  
  METHODS
  Retrospective medical record review.
  
  
  METHODS
  County hospital with surgical residency.
  
  
  METHODS
  A total of 194 patients underwent the sentinel node procedure.
  
  
  METHODS
  Sentinel node procedure with methylene blue or isosulfan blue.
  
  
  METHODS
  The identification rate, number of sentinel nodes identified, clinicopathologic variables, adverse effects, and complications were compared between the 2 groups.
  
  
  RESULTS
  The sentinel node identification rate was similar between the 2 groups (99.1% with methylene blue and 100.0% with isosulfan blue). Slightly more sentinel nodes were identified using methylene blue (mean, 2.7 vs 2.1; P = .03). No allergic reactions were seen. Significantly more patients experienced a change in pulse oximetry readings, a wider range of pulse oximetry reduction, and a greater mean decrease in pulse oximetry readings with isosulfan blue than with methylene blue. No skin complications were seen in either group. A palpable mass occurred at the site of methylene blue injection in 8.2% of patients.
  
  
  CONCLUSIONS
  The sentinel node identification rate was similar with methylene blue and with isosulfan blue. Methylene blue has significant advantages with respect to product cost, absence of anaphylactic reactions, and lack of interference with pulse oximetry. However, awareness is necessary of the possibility of injection site mass after methylene blue injection.
authors.affiliation: Department of Surgery, Maricopa Medical Center, Phoenix, Arizona 85008, USA.
authors.forename: Gina R
authors.initials: GR
authors.lastname: Shirah
authors.forename: Marcia E
authors.initials: ME
authors.lastname: Bouton
authors.forename: Ian K
authors.initials: IK
authors.lastname: Komenaka
mesh_terms: D001943:Breast Neoplasms / Q000556:secondary*; D004396:Coloring Agents / Q000008:administration & dosage; D005218:Fat Necrosis / Q000139:chemically induced* / Q000473:pathology; D005260:Female; D006801:Humans; D007267:Injections; D008207:Lymphatic Metastasis; D008751:Methylene Blue / Q000008:administration & dosage / Q000009:adverse effects*; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012394:Rosaniline Dyes / Q000008:administration & dosage; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*
chemical_list: D004396:Coloring Agents; D012394:Rosaniline Dyes; C025484:iso-sulfan blue; D008751:Methylene Blue