What is the dye injection technique for breast cancer lymphoscintigraphy (sentinel lymph node mapping)?

Updated: Dec 13, 2018
  • Author: Durre Sabih, MBBS, MSc, FRCP(Edin); Chief Editor: Mahan Mathur, MD  more...
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Answer

Answer

Methylene blue, patent blue, or isosulfan blue injections are used alone or in conjunction for sentinel node identification. [22] The injection is given in the operation theater 5 minutes before the surgical incision. The injection is subdermal, peritumoral, or subareolar. (See the image below.)

Methylene blue is injected in the operating theate Methylene blue is injected in the operating theater. Note the larger volume and a deeper insertion angle.

A volume of approximately 1.5-2 mL is used for subdermal injections, whereas a larger volume of about 5 mL (divided into 2 aliquots) is used for peritumoral injections. The injection site is massaged as for the radiopharmaceutical injection.

A positive test is when a node is colored blue, often with a blue channel leading to it.

Note that there may be generalized blue coloration of the body, and some patients may experience allergic reaction to the dye.


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