Blue dye versus combined blue dye—radioactive tracer technique in detection of sentinel lymph node in breast cancer

Radovanović, Zoran; Golubovic, A.; Plzak, A.; Stojiljković, Bratislav; Radovanović, Dragana

doi:10.1016/j.ejso.2004.08.003

Cited by 70 publications

(43 citation statements)

References 27 publications

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“…Motomura et al reported a 19% false negative rate in a group of patients who underwent sentinel node biopsy with the blue-dye technique (12). Similarly, Radovanovic et al reported a rate of 17% false negatives in their group of 50 patients (14). We are sure that the differences between the false negative rate in our study and false negative rates reported in other studies are caused by technical differences.…”

Section: Discussioncontrasting

confidence: 55%

“…When complete axillary dissection is limited to the patients with SN involvement, the combined technique for sentinel node biopsy is widely recommended (11,13,14). The use of radiocolloid followed by limphoscintygraphy provides information regarding the localization and number of sentinel nodes prior to surgery.…”

Section: Discussionmentioning

confidence: 99%

“…The best results are achieved when two tracers are used. Therefore, concurrent use of radiotracer and blue dye is suggested if complete axillary dissection is to be abandoned (11)(12)(13)(14). Despite low activity, the use of a radioactively labeled tracer poses a risk of exposure to radiation for the medical staff performing the sentinel node biopsy (15,16).…”

mentioning

confidence: 99%

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A Blue-Dye-Only, Wide-Axillary-Access Technique for Sentinel Node Biopsy in Breast Cancer Patients Undergoing Elective Complete Axillary Dissection

Pluta¹,

Piekarski²,

Nejc³

et al. 2008

Polish Journal of Surgery

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The aim of the study was to assess the value of a sentinel node biopsy with the use of a blue-dye-only technique as a tool for ultrastaging breast cancer in patients undergoing axillary lymphadenectomy. In order to maximize the efficacy of the method, we used a specific technique identifying blue-dyed lymph vessels during surgery. We took advantage of the wide surgical access to axillary lymph nodes. Material and methods. A blue dye technique for sentinel node biopsy was used during a modified radical mastectomy (Madden type) in 34 patients (85%) or during breast-conserving surgery with complete axillary dissection in six patients (15%). Results. The sentinel node(s) was identified in 39 of the 40 patients (97.5%). Metastases were detected in sentinel nodes in 14 out of these 39 patients. In one patient (1/39; 2.5%), micrometastasis was identified. The false-negative rate was 0%, sensitivity 100%, and negative-predictive value 100%. Conclusions. The blue dye method for sentinel node biopsy with wide access to the axilla is an effective and reliable tool for the identification of the sentinel node. The use of this simple technique permits ultrastaging of breast cancer patients undergoing complete axillary dissection.

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

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A Blue-Dye-Only, Wide-Axillary-Access Technique for Sentinel Node Biopsy in Breast Cancer Patients Undergoing Elective Complete Axillary Dissection

Pluta¹,

Piekarski²,

Nejc³

et al. 2008

Polish Journal of Surgery

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“…Although blue dye does not have such issues, it may lead to skin discoloration, decrease in saturation, allergies, anaphylactic reactions, injection site nodules and fat necrosis (6)(7)(8)(9)(10). The SLN detection rates are lower in SLNB with blue dye alone as compared to radiocolloid use (11)(12)(13). Indocyanine green (ICG) is a non-toxic and non-ionized substance that not extravased by binfing to lipoproteins, has a short life-time has a fluorescence in near infrared (NIR) wavelengths, and enables tracing the lymphatic flow through the tissue with charged-couple device (CCD) (14).…”

Section: Introductionmentioning

confidence: 98%

Sentinel lymph node biopsy under fluorescent indocyanin green guidance: Initial experience

Aydoğan

Arıkan

Aytaç

et al. 2016

UCD

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Objective: Sentinel lymph node biopsy can be applied by using either blue dye or radionuclide method or both in breast cancer. Fluorescent imaging with indocyanine green is a new defined method. This study evaluates the applicability of sentinel lymph node biopsy via fluorescent indocyanine green.Material and Methods: IC-VIEW (Pulsion Medical Systems AG, Munich, Germany) infrared visualization system was used for imaging. Two mL of indocyanine green was injected to visualize sentinel lymph nodes. After injection, subcutaneous lymphatics were traced and sentinel lymph nodes were found with simultaneous imaging. Sentinel lymph nodes were excised under fluorescent light guidance, and excised lymph nodes were examined histopathologically. Patients with sentinel lymph node metastases underwent axillary dissection.Results: Four patients with sentinel lymph node biopsy due to breast cancer were included in the study. Sentinel lymph nodes were visualized with indocyanine green in all patients. The median number of excised sentinel lymph node was 2 (2-3). Two patients with lymph node metastasis underwent axillary dissection. No metastasis was detected in lymph nodes other than the sentinel nodes in patients with axillary dissection. There was no complication during and after the operation related to the method. Conclusion:According to our limited experience, sentinel lymph node biopsy under fluorescent indocyanine green guidance, which has an advantage of simultaneous visualization, is technically feasible.

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“…Thus, the detection subsequent to skin incision in the armpit involves a nuclear probe. Blue dye, such as patent blue V (PBV), is used to provide visual guidance during the surgical procedure (5,6). Potential allergy to PBV dye has recently been thoroughly studied and severe anaphylaxis is rare, approximately 0.9% (7).…”

Section: Introductionmentioning

confidence: 99%

A new optical probe for the detection of the sentinel lymph node using patent blue V dye in breast cancer: A preliminary study

Tellier

Poulet

Ghnassia³

et al. 2012

Molecular and Clinical Oncology

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Abstract. The present study presents a novel near-infrared optical probe for the sentinel lymph node (SLN) detection in breast cancer patients, based on the recording of scattered photons. The aim of this study was to improve the detection of patent blue V (PBV), a dye routinely injected during clinical practice. A combined injection of the dye and radioactive colloid was used in the 24 patients enrolled in the study. The clinical results of the ex vivo detection of 70 dye-marked SLNs are reported, subsequent to the injection of various quantities of PBV (0.25-2 ml). The accuracy and success rate of an isotopic probe for the detection of radioactive colloid tracer, the eye visibility threshold of the surgeon and the use of a new optical probe were examined. The radio-labeled and dye-marked sentinel lymph nodes were all detected by the radio-isotopic probe, as opposed to the 75% detected by the eye visibility threshold of the surgeon. The optical probe detected all of the nodes, regardless of the volume of the dye injected. The relative PBV concentration computed by the probe facing SLNs with infravisible/visually undetectable dye-mark was relatively constant at 5.5±1.4 µmol/l. The optical detection of the sentinel lymph nodes using PBV and the probe presented in this study have the potential to reduce the false negative detection rate. This instrument is likely to provide surgeons with a simple diagnostic tool, without significantly changing their surgical procedures. IntroductionIn France, approximately 40% of the newly diagnosed cancer in female patients is breast cancer. The mapping and excision of sentinel lymph nodes is the main minimally invasive technique for cancer staging. The morbidity associated with this technique is less compared to the axillary dissection (1). The procedure used in routine clinical practice is clearly defined. Combined blue dye and isotope injection in the periareolar area allows for the identification of the sentinel lymph node (SLN) at a higher success rate (2-4). Thus, the detection subsequent to skin incision in the armpit involves a nuclear probe. Blue dye, such as patent blue V (PBV), is used to provide visual guidance during the surgical procedure (5,6). Potential allergy to PBV dye has recently been thoroughly studied and severe anaphylaxis is rare, approximately 0.9% (7). However, this detection method involves an element of subjectivity and requires a learning curve on behalf of the surgeon (8).Currently, attempts have been made to develop accurate and minimally invasive diagnostic and interventional tools. Thus, several optical methods are currently being developed in parallel with conventional methods, such as magnetic resonance imaging (MRI) (9), positron emission tomography (PET) (10) or ultrasound (11), to detect SLN. The use of tracers with radiocolloid metastable technetium 99 ( 99m Tc) and fluorescent labeling (ICG) is widely suggested (12). Moreover, the photoacoustic approach using nanoparticules has increasingly been considered in several studies (13). However,...

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Blue dye versus combined blue dye—radioactive tracer technique in detection of sentinel lymph node in breast cancer

Cited by 70 publications

References 27 publications

A Blue-Dye-Only, Wide-Axillary-Access Technique for Sentinel Node Biopsy in Breast Cancer Patients Undergoing Elective Complete Axillary Dissection

A Blue-Dye-Only, Wide-Axillary-Access Technique for Sentinel Node Biopsy in Breast Cancer Patients Undergoing Elective Complete Axillary Dissection

Sentinel lymph node biopsy under fluorescent indocyanin green guidance: Initial experience

A new optical probe for the detection of the sentinel lymph node using patent blue V dye in breast cancer: A preliminary study

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