The use of radioisotope combined with isosulfan blue dye is not superior to radioisotope alone for the identification of sentinel lymph nodes in patients with breast cancer

Prospective comparison of peritumoral and subareolar injection of blue dye alone, for identification of sentinel lymph nodes in patients with early stage breast cancer

“…Finally results from the ALMANAC study show that although the identification rate of the combined method was superior to BD alone (85.6% vs. 96%), there was no significant difference between the two techniques in identifying the positive nodes [10]. In contrast to these studies, other investigators do not find any evidence of higher identification rate of the combined technique versus blue dye alone [16,17] or radioisotope alone [18].…”

Superiority of Radioisotope over Blue Dye for Sentinel Lymph Node Detection in Breast Cancer

“…For instance, Cody et al [4] reported in his series of 966 cases that radioisotopes and blue dye complement each other, and remarked that both methods should be used for SLNB in breast cancer. There is, however, another report published in 2008 suggesting that the blue dye method did not enhance the performance of SLNB in an examination of 392 cases [5] . This controversial issue concerning the appropriate choice of lymphatic mapping reagents still remains to be elucidated.…”

Localization of the Sentinel Lymph Node in Melanoma Without Blue Dye

“…10–13 In the setting of breast cancer, compared with radioguidance alone, the combined modality of blue dye plus radioguidance confers only a 2% localization rate advantage. 14, 15 Juxtaposed against this marginal benefit are rare but potentially serious adverse events associated with blue dye, including prolonged cutaneous staining, 3 skin reactions, and anaphylaxis rates ranging from 0.1–2.7%. 16–19 Finally, because Medicare does not allow for separate reporting of vital dye injection for reimbursement, its routine use may also incur unnecessary costs to the provider.…”