Methylene Blue for Localization of Sentinel Lymph Nodes in Breast Cancer: A Comparison with Isosulfan Blue

摘要

Purpose Isosulfan blue dye has been widely used for localizing sentinel lymph nodes (SLNs) in breast cancer patients. The use of methylene blue has recently been applied for localizing SLNs. We compared the use of each dye to investigate the effectiveness of methylene blue for the localization of SLNs. Methods From January to December of 2005, 326 patients underwent surgery for breast cancer at Samsung Medical Center. In 86 patients, only a blue dye was used for SLN localization. Isosulfan blue and methylene blue were randomly given. Each dye (5 mL) was given by subareolar or peritumoral injection. The injection site was gently massaged with a warm gauze for 5 min. A frozen biopsy was performed for all SLNs, and an axillary dissection was done for positive frozen biopsy cases or cases in which axillary metastasis was clinically suspected. Results Fifty-eight cases (61.1%) had been treated with isosulfan blue and 37 cases (38.9%) had been treated with methylene blue. Blue nodes were found in 96.6% of samples in the isosulfan blue group and 86.5% of samples in the methylene blue group. The mean number of SLNs was 2.10 in the isosulfan blue group and 2.27 in the methylene blue group ( p >0.05). The frozen biopsy was positive for malignant cells in 16 of 56 cases in the isosulfan blue group and 4 of 32 cases in the methylene blue group. Axillary lymph node dissection was performed in 23 cases in the isosulfan blue group and 19 cases in the methylene blue group. Conclusion There are no significant differences in the success rate, the mean number of SLNs found and the false negative rate between the use of isosulfan blue and methylene blue for localization of SLNs in breast cancer patients.