Blue dye is sufficient for sentinel lymph node biopsy in breast cancer

Ang, C. H.; Tan, Mark; Teo, C. J.; Seah, Dse; Chen, J C; Chan, Madelynn; Tan, Elaine

doi:10.1002/bjs.9390

Cited by 24 publications

(17 citation statements)

References 34 publications

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“…Simon first reported that MBD could serve as an alternative to isosulfan blue in combination with radioisotopes for SNB in breast cancer[ 17 ], and similar conclusions were drawn by other researchers[ 18 – 21 ]. Recently, several studies reported that blue dye alone was sufficient for identifying SNs in breast cancer [ 22 – 24 ]. Thus, the use of MBD alone as a mapping method for SNB seems feasible and may expand the use of SNB in developing countries.…”

Section: Introductionmentioning

confidence: 99%

Sentinel lymph node biopsy mapped with methylene blue dye alone in patients with breast cancer: A systematic review and meta-analysis

Xiao

et al. 2018

PLoS ONE

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BackgroundMethylene blue dye is easy to obtain in developing countries and can be used in sentinel lymph node mapping for breast cancer. However, the accuracy of methylene blue alone for sentinel lymph node mapping in breast cancer has not been well defined. In this study, we collected data to assess the feasibility and accuracy of sentinel lymph node biopsy mapped with methylene blue alone in patients with breast cancer.MethodsWe searched the PubMed, EMBASE, and Cochrane Library databases from January 1, 1993, to March 31, 2018. Selected studies had to have a defined group of patients with breast cancer in which MBD alone was used as the mapping technique for SNB.Results18 studies were included in this study. The combined identification rate was 91% [95% confidence interval (CI): 88%-94%, I2 = 68.3%], and the false negative rate was 13% (95% CI: 9%-18%, I2 = 36.7%). The pooled sensitivity, negative predictive value, and accuracy rate were 87% (95% CI: 82%-91%, I2 = 37.5%), 91% (95% CI: 87%-93%, I2 = 32.4%) and 94% (95% CI: 92%-96%, I2 = 29%), respectively.ConclusionsThis meta-analysis found that mapping sentinel lymph node locations with methylene blue dye alone results in an acceptable identification rate but an excessive false negative rate according to the American Society of Breast Surgeons’ recommendations. Caution is warranted when using methylene blue dye alone as the mapping method for sentinel lymph node biopsy.

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Section: Introductionmentioning

confidence: 99%

Sentinel lymph node biopsy mapped with methylene blue dye alone in patients with breast cancer: A systematic review and meta-analysis

Xiao

et al. 2018

PLoS ONE

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“…If the MRI artefact due to residual magnetic tracer still poses a problem, SLNB can be performed using other tracers. (19)(20)(21) Patients requiring pre-operative MRI imaging, for instance patients undergoing primary chemotherapy, are eligible for localization using these magnetic markers but since the artefacts on MRI are large and will impact on the ability to report on response to treatment, the magnetic markers should be placed immediately prior to surgery, after completion of primary chemotherapy. It might also be possible to decrease the artefact, by making the magnetic markers thinner or by lowering the iron content of these magnetic markers.…”

Section: Discussionmentioning

confidence: 99%

Feasibility study evaluating a magnetic marker in an ex-vivo porcine model

Peek

Zada

Ahmed

et al. 2018

Journal of Magnetism and Magnetic Materials

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“…[10][11][12] False-negative rates are low and a negative SLN is now accepted as being representative of node-negative disease. [13][14][15] The recent American College of Surgeons Oncology Group Z0011 trial has further shown that axillary lymph node dissection can be omitted in women with low-burden SLN disease who receive adjuvant whole breast irradiation and chemotherapy. 16 Since SLN biopsy involves only a limited dissection of the low level I axilla, potential complications of postoperative bleeding from a slipped clip or ligature, or oozing from the surgical bed and seroma formation is minimal, obliterating the need for surgical drains.…”

Section: Introductionmentioning

confidence: 99%

Ambulatory surgery for the patient with breast cancer: current perspectives

Pek¹,

Tey²,

Tan³

2016

OAS

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Ambulatory breast cancer surgery is well accepted and is the standard of care at many tertiary centers. Rather than being hospitalized after surgery, patients are discharged on the day of surgery or within 23 hours. Such early discharge does not adversely affect patient outcomes and has the added benefits of better psychological adjustment for the patient, economic savings, and a more efficient utilization of health care resources. The minimal care needed post-discharge also means that the caregiver is not unduly burdened. Unplanned conversions to inpatient admission and readmission rates are low. Wound complications are infrequent and no issues with drain care have been reported. Because the period of postoperative observation is short and monitoring is not as intensive, ambulatory surgery is only suitable for low-risk procedures such as breast cancer surgery and in patients without serious comorbidities, where the likelihood of major perioperative events is low. Optimal management of pain, nausea, and vomiting is essential to ensure a quick recovery and return to normal function. Regional anesthesia such as the thoracic paravertebral block has been employed to improve pain control during the surgery and in the immediate postoperative period. The block provides excellent pain relief and reduces the need for opiates, which also consequently reduces the incidence of nausea and vomiting. The increasing popularity of total intravenous anesthesia with propofol has also helped reduce the incidence of nausea and vomiting in the postoperative period. Ambulatory surgery can be safely carried out in centers where there is a well-designed workflow to ensure proper patient selection, counseling, and education, and where patients and caregivers have easy access to medical services should problems arise after discharge.

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Blue dye is sufficient for sentinel lymph node biopsy in breast cancer

Abstract: Blue dye performed well as a single modality for SLN biopsy. Non-identification, axillary nodal recurrence and serious allergic reactions were uncommon.

Cited by 24 publications

References 34 publications

Sentinel lymph node biopsy mapped with methylene blue dye alone in patients with breast cancer: A systematic review and meta-analysis

Sentinel lymph node biopsy mapped with methylene blue dye alone in patients with breast cancer: A systematic review and meta-analysis

Feasibility study evaluating a magnetic marker in an ex-vivo porcine model

Ambulatory surgery for the patient with breast cancer: current perspectives

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