RT Journal
A1 Shirah GR, Bouton ME, Komenaka IK
T1 OCcurrence of prolonged injection site mass with methylene blue but not isosulfan blue after the sentinel node procedure
JF Archives of Surgery
JO Archives of Surgery
YR 2011
FD February 1
VO 146
IS 2
SP 137
OP 141
DO 10.1001/archsurg.2010.330
UL http://dx.doi.org/10.1001/archsurg.2010.330
AB Hypothesis 
    Methylene blue and isosulfan blue perform similarly in the sentinel node procedure.Design 
    Retrospective medical record review.Setting 
    County hospital with surgical residency.Patients 
    A total of 194 patients underwent the sentinel node procedure.Intervention 
    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.Results 
    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.Conclusions 
    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.