Prolonged Injection Site Mass Can Occur with Methylene Blue but Not Lymphazurin Blue after the Sentinel Node Procedure
| Autor: | G. Shirah, Marcia E. Bouton, Ian K. Komenaka |
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| Rok vydání: | 2009 |
| Předmět: | |
| Zdroj: | Cancer Research. 69:3115-3115 |
| ISSN: | 1538-7445 0008-5472 |
| DOI: | 10.1158/0008-5472.sabcs-09-3115 |
| Popis: | Objectives: The purpose of this study is to evaluate the differences in outcomes and complications of the sentinel node dissection for breast cancer using Methylene blue and Lymphazurin blue.Methods: From 2004-2008, 160 patients underwent the sentinel node procedure at a county hospital, teaching institution. The sentinel node procedure was performed using the combined technique of blue dye and radioactive isotope. From 2004 to June 2006, Lymphazurin blue (LB) was used. From July 2006 to 2008, Methylene blue (MB) was used. Axillary dissection was performed if the sentinel node procedure revealed positive lymph nodes or failed.Results: Fifty patients underwent the sentinel node procedure with LB and 110 underwent the procedure with MB. The patients were of similar age and stage of presentation. More patients in the MB group were Hispanic and underwent preoperative chemotherapy. The sentinel node identification rate was 100% in the LB group and 99% in the MB group (P = 1.0). The mean numbers of sentinel lymph nodes were similar (LB 2.2 vs. MB 2.7). In the LB group 34% of patients were lymph node positive compared to 40% in the MB group.There were no allergic reactions in either group. The infection rate in the breast was similar in both groups LB (2%) and MB (1.8%). Previous studies have reported skin manifestations of necrosis, ulceration, tattooing, erythema, rash, or telangiectasia/vascular change at the site of injection with methylene blue. These findings were not seen in any of the patients in this study. In ten of the 110 patients (9%) who underwent the procedure with MB, however, a local inflammatory reaction occurred which resulted in a palpable mass at the site of injection. No injection site reactions were noted in LB group. In the MB group, the masses were clearly more prominent than the surrounding breast tissue and identified either at the one week postoperative check (6) or at the first 6-month followup (4). Ultrasound of the injection sites did reveal a hypoechoic mass in one patient. Biopsies were performed on the first four patients, but revealed only inflammation and non-atypical hyperplasia. Nearly all of the masses resolved by one year, however, one resolved after 18 months.Conclusion: Methylene blue is a reasonable alternative to lymphazurin blue in the sentinel node procedure for breast cancer. Awareness of injection site reactions to MB are important, as a new dominant mass is always reason for concern in breast cancer patients. Palpable mass at the site of MB injection can occur but typically resolve over a one year period. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3115. |
| Databáze: | OpenAIRE |
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