In SLNB techniques various studies like Giuliano et al used Isosulfan blue dye
(4 ml of 1% sigma--Aldrich Milwaukee W1 USA)
Incidence of anaphylactoid reactions to isosulfan blue dye
during breast carcinoma lymphatic mapping in patients treated with preoperative prophylaxis: Results of a surgical prospective clinical practice protocol.
Localization of Nonpalpable Breast Lesions Using Hook-Wire Combined with Isosulfan Blue Dye
. J Surg Oncol 2003; 82: 73-74.
In order to localize SLN, either a combination of direct visualization technique, employing Isosulfan Blue dye
and scintigraphy, is used4-6 or scintigraphic technique alone is employed7.
However, there are occasional allergic reactions to the blue dyes, including anaphylactic reactions, urticaria, rash, blue hives, and pruritus associated with isosulfan blue dye
and skin necrosis associated with nondiluted methylene blue.
Combined use of radioactive colloid and blue dye injection is considered as gold standard for axillary sentinel lymph node biopsy (SLNB) in breast cancer with 97% accuracy rate,8-10 but this combine usage does not attain an adequately higher detection rate to defend the cost.11 While some researchers have been using blue dye only for identification of SLN with good reliability.12 The positive results found by using methylene blue dye and by isosulfan blue dye
were 99% and 97% respectively.13,14 While another similar study for methylene blue dye was done showing the sensitivity and specificity of 85.7% and 71.4% respectively.15
The results with the methylene blue were also disappointing; however, Isosulfan blue dye
is not available at our institution due to the cost.
After 50 min of injection, 0.1ml isosulfan blue dye
was injected intradermally in the both foot pads.
Anaphylactic reactions to isosulfan blue dye
during sentinel node lymphadenectomy for breast cancer.
A combination of radioactive technetium-99m sulfur colloid (Tc-99m SC) plus isosulfan blue dye
is used to increase the sensitivity of SLN mapping and biopsy However, a recent article recommended the use of only Tc-99m SC in pregnant women because of the risk of allergic reactions (up to 2%) and life-threatening anaphylaxis (0.7%-1.1%) associated with the blue dye (Cancer 2003;97:2130-3).
The "very preliminary" pilot data indicate that the intraoperative combination of isosulfan blue dye
and gamma probe detection of radiocolloid may be a diagnostically accurate method of detecting lymph node disease in patients with stage IB1 cervical cancer (less than 4 cm in size).
Isosulfan blue dye
was used for mapping in these studies.