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.

Abstract

BACKGROUND:

Isosulfan Blue dye (BD) allergic drug reactions (ADR) occur in up to 2% of patients undergoing SLN biopsy (SLNB). We sought to determine if BD enhances the performance of SLNB such that this risk is justified.

METHODS:

A retrospective review of 392 breast cancer patients undergoing SLNB between 8/99 and 8/04 was performed; 208 patients had radioisotope (ISO) alone, 167 had ISO+BD. Total SLN and positive SLN in each group were compared. We examined the ISO+BD group for concordance and the presence of blue only nodes. The effect of tumor location, injection site, angiolymphatic invasion, Her2/neu expression, and the presence of a noninvasive component were studied. Chi-square, linear regression, Fisher t tests, and ANOVA were performed.

RESULTS:

SLN were identified in 94% of ISO and 96% of ISO+BD patients. The mean number SLN from the ISO group was 2.01, 1.93 for ISO+BD; 27% of ISO and 21% of ISO+BD patients had positive nodes. These differences were not significant. No difference for tumor location, injection site, angiolymphatic invasion, Her2/neu expression, or the presence of a noninvasive component was found.

CONCLUSION:

The addition of BD to ISO in patients with invasive breast cancer does not significantly enhance the performance of SLNB.

• Authors: Steven Bines, Katherine Kopkash, Amjad Ali, Louis Fogg, Norman Wool
• Journal: Surgery (Surgery) Vol. 144 Issue 4 Pg. 606-9; discussion 609-10 (Oct 2008) ISSN: 1532-7361 [Electronic] United States
• PMID: 18847645 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Coloring Agents
• Radioisotopes
• Rosaniline Dyes
• iso-sulfan blue

Topics

• Adult
• Aged
• Analysis of Variance
• Breast Neoplasms (diagnosis, pathology)
• Chi-Square Distribution
• Cohort Studies
• Coloring Agents (adverse effects)
• Drug Hypersensitivity (etiology, physiopathology)
• Female
• Humans
• Linear Models
• Middle Aged
• Neoplasm Invasiveness (pathology)
• Neoplasm Staging (methods)
• Radioisotopes
• Retrospective Studies
• Risk Assessment
• Rosaniline Dyes (adverse effects)
• Sensitivity and Specificity
• Sentinel Lymph Node Biopsy (methods)