653 Adverse Effects of Isosulfan Blue Dye in Sentinel Lymph Node Mapping in Breast Cancer: A meta-analysis

Aim The aim of the study is to investigate the available evidence on the adverse effects of the use of isosulfan blue dye in sentinel lymph node mapping in breast cancer patients and to determine the treatment modalities for such complications. Method We carried out a thorough search of relevant articles in PubMed, Medline and Embase databases using the PRISMA guideline. Studies reporting on the adverse effects of isosulfan blue dye were included. Adverse effects were subdivided into 3 groups: Grade I, Grade II and Grade III. Weighted means were extracted and evaluated for procedure adverse reactions. A meta-analysis of proportion was conducted using random-effect models to analyse adverse effects rates. Results Grade I reactions were seen in 184 patients, Grade II in 4 patients and 50 patients developed Grade III reactions. The total rate of adverse reactions was 1.10% [CI: 0.96 to 1.26]; Grade I reaction rate was 0.82% [CI: 0.70 to 0.96], Grade II reaction rate was 0.02% [CI: 0.006 to 0.054] and Grade III reaction rate was 0.24% [CI = 0.18 to 0.32]. Conclusions Currently, there is no level 1 evidence (meta-analysis) in the literature on the use of isosulfan blue dye in sentinel lymph node mapping in breast cancer patients. In our study, despite the low adverse reaction rate of isosulfan use, clinicians should still be aware of such complications following administration to ensure prompt treatment.

Rate of sentinel lymph node identification using isosulfan blue dye in breast cancer patients at Charoenkrung Pracharak Hospital, Thailand

Background: The sentinel lymph node (SLN) is the first lymph node to receive lymphatic drainage from a primary breast tumor. If the SLN contains no metastatic tumor, then it is unlikely other lymph nodes will contain breast cancer metastasis. When the SLN does contains metastasis, an axillary lymph node dissection (ALND) is recommended to further stage the axilla and to maintain locoregional control. SLNs can be identified by using a dye, radioisotope, or combined techniques. Objective: To determine the rate of SLN identification using isosulfan blue dye in breast cancer patients at Charoenkrung Pracharak Hospital, Thailand, and factors that affect it. Methods: This prospective study of 106 consecutive cases breast cancer enrolled 105 women (1 bilateral breast cancer case) between October 2011 and October 2013 at Charoenkrung Pracharak Hospital. Clinical and pathological features were analyzed for the effectiveness of SLN identification using isosulfan blue dye. Results: The rate of SLN identification using isosulfan blue dye in breast cancer patients at Charoenkrung Pracharak Hospital was 92%. The method was safe and well tolerated in early-stage breast cancer patients. Conclusion: The effectiveness of sentinel node identification using isosulfan blue dye in breast cancer patients at Charoenkrung Pracharak Hospital is consistent with that shown in studies from other countries.