Is blue dye still required during sentinel lymph node biopsy for breast cancer?

Mirjam C L Peek, T. Kovács, Rose Baker, Hisham Hamed, Ash Kothari, Michael Douek

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: In early breast cancer, the optimal technique for sentinel lymph node biopsy (SLNB) is the combined technique (radioisotope and Patent Blue V) which achieves high identification rates. Despite this, many centres have decided to stop using blue dye due to blue-dye-related complications (tattoo, anaphylaxis). We evaluated the SLNB identification rate using the combined technique with and without Patent Blue V and the blue-dye-related complication rates. Methods: Clinical and histological data were analysed on patients undergoing SLNB between March 2014 and April 2015. SLNB was performed following standard hospital protocols using the combined technique. Results: A total of 208 patients underwent SLNB and 160 patients (342 nodes) with complete operation notes were available for final analysis. The identification rate with the combined technique was 98.8% (n = 158/160), with blue dye alone 92.5% (n = 148/160) and with radioisotope alone 97.5% (n = 156/160). A total of 76.9% (263/342) of nodes were radioactive and blue, 15.5% (53/342) only radioactive and 2.3% (8/342) only blue, 5.3% (18/342) were neither radioactive nor blue. No anaphylactic reactions were reported and blue skin staining was reported in six (3.8%) patients. Conclusion: The combined technique should continue be the preferred technique for SLNB and should be standardised. Radioisotope alone (but not blue dye alone) has comparable sentinel node identification rates in experienced hands. National guidelines are required to optimise operative documentation.

Original languageEnglish
Article number674
Journalecancermedicalscience
Volume10
DOIs
Publication statusPublished - Sep 19 2016

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Sentinel Lymph Node Biopsy
Coloring Agents
Breast Neoplasms
Radioisotopes
Anaphylaxis
Documentation
Guidelines
Staining and Labeling
Skin

Keywords

  • Breast cancer
  • Patent blue
  • Radioisotope
  • Sentinel lymph node biopsy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Is blue dye still required during sentinel lymph node biopsy for breast cancer? / Peek, Mirjam C L; Kovács, T.; Baker, Rose; Hamed, Hisham; Kothari, Ash; Douek, Michael.

In: ecancermedicalscience, Vol. 10, 674, 19.09.2016.

Research output: Contribution to journalArticle

Peek, Mirjam C L ; Kovács, T. ; Baker, Rose ; Hamed, Hisham ; Kothari, Ash ; Douek, Michael. / Is blue dye still required during sentinel lymph node biopsy for breast cancer?. In: ecancermedicalscience. 2016 ; Vol. 10.
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abstract = "Background: In early breast cancer, the optimal technique for sentinel lymph node biopsy (SLNB) is the combined technique (radioisotope and Patent Blue V) which achieves high identification rates. Despite this, many centres have decided to stop using blue dye due to blue-dye-related complications (tattoo, anaphylaxis). We evaluated the SLNB identification rate using the combined technique with and without Patent Blue V and the blue-dye-related complication rates. Methods: Clinical and histological data were analysed on patients undergoing SLNB between March 2014 and April 2015. SLNB was performed following standard hospital protocols using the combined technique. Results: A total of 208 patients underwent SLNB and 160 patients (342 nodes) with complete operation notes were available for final analysis. The identification rate with the combined technique was 98.8{\%} (n = 158/160), with blue dye alone 92.5{\%} (n = 148/160) and with radioisotope alone 97.5{\%} (n = 156/160). A total of 76.9{\%} (263/342) of nodes were radioactive and blue, 15.5{\%} (53/342) only radioactive and 2.3{\%} (8/342) only blue, 5.3{\%} (18/342) were neither radioactive nor blue. No anaphylactic reactions were reported and blue skin staining was reported in six (3.8{\%}) patients. Conclusion: The combined technique should continue be the preferred technique for SLNB and should be standardised. Radioisotope alone (but not blue dye alone) has comparable sentinel node identification rates in experienced hands. National guidelines are required to optimise operative documentation.",
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