Incidence of adverse reactions to patent blue dye in melanoma sentinel node biopsy: A major UK centre experience

摘要

The MHRA issued a warning regarding Patent Blue Dye in February 2012 in response to a concern regarding life-threatening reactions to the dye. This dye is routinely used in sentinel node biopsies for both breast cancer and melanoma. The warning is based primarily on data from the use of patent blue dye in breast cancer sentinel node biopsy therefore the it was decided to review the melanoma SNB database at St George's to determine whether we too were experiencing similar rates of adverse reactions.On review of the database we observed that we had not encountered any cases of life-threatening reactions and a rate of only 0.056% for adverse reactions. This difference in adverse reaction incidence noted for melanoma may be explained by a number of hypotheses. The timing, volumes of dye used and where the dye is injected may all be part of an explanation for the difference in observed rates of adverse reactions in melanoma when compared to breast cancer SNB. The MHRA warning suggests we should also routinely explain the risks of the dye during consent, As our experiences do not seem to reflect the same risk we would not routinely mention this during consent. Although we would encourage all units to review their own experiences in order to guide their policy on consent for SNB.