Methylene blue and isosulfan blue perform similarly in the sentinel node procedure.
Retrospective medical record review.
County hospital with surgical residency.
A total of 194 patients underwent the sentinel node procedure.
Sentinel node procedure with methylene blue or isosulfan blue.
Main Outcome Measures
The identification rate, number of sentinel nodes identified, clinicopathologic variables, adverse effects, and complications were compared between the 2 groups.
The sentinel node identification rate was similar between the 2 groups (99.1% with methylene blue and 100.0% with isosulfan blue). Slightly more sentinel nodes were identified using methylene blue (mean, 2.7 vs 2.1; P = .03). No allergic reactions were seen. Significantly more patients experienced a change in pulse oximetry readings, a wider range of pulse oximetry reduction, and a greater mean decrease in pulse oximetry readings with isosulfan blue than with methylene blue. No skin complications were seen in either group. A palpable mass occurred at the site of methylene blue injection in 8.2% of patients.
The sentinel node identification rate was similar with methylene blue and with isosulfan blue. Methylene blue has significant advantages with respect to product cost, absence of anaphylactic reactions, and lack of interference with pulse oximetry. However, awareness is necessary of the possibility of injection site mass after methylene blue injection.