Isosulfan Blue Dye Reactions During Sentinel Lymph Node Mapping for Breast Cancer
- 1 August 2002
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Anesthesia & Analgesia
- Vol. 95 (2), 385-388
- https://doi.org/10.1097/00000539-200208000-00026
Abstract
In the United States, identification of the sentinel lymph node (SLN) requires the use of (99m)Tc-labeled colloid, 1% isosulfan blue dye, or both to trace the lymphatic drainage of a given neoplasm. We report our experience with adverse reactions to isosulfan blue dye during SLN mapping in breast cancer. A chart review of the breast cancer SLN database was performed; it included 2392 sequential patients who underwent SLN biopsy involving isosulfan blue dye at Memorial Sloan-Kettering Cancer Center from September 12, 1996, to August 17, 2000. Thirty-nine of 2392 patients (1.6%) had a documented allergic reaction during the mapping procedure. Most reactions (69%) produced urticaria, blue hives, a generalized rash, or pruritus. The incidence of hypotensive reactions was 0.5%. Although anaphylaxis after the injection of isosulfan blue dye is rare, this article highlights the need to suspect anaphylaxis when hemodynamic instability occurs after the injection of this compound. Our experience indicates that bronchospasm and respiratory compromise are unusual and that most patients do not require emergent intubation and can be managed with short-term pressor support. In addition, our data indicate that patients with a sulfa allergy do not display a cross-sensitivity to isosulfan blue dye. We report the largest single-institution review of adverse reactions to injection of isosulfan blue dye during sentinel lymph node mapping in breast cancer. Bronchospasm and respiratory compromise are unusual, and most patients can be treated with short-term pressor support. Patients with a sulfa allergy do not display a cross-sensitivity to isosulfan blue dye.Keywords
This publication has 18 references indexed in Scilit:
- Anaphylactic reactions to isosulfan blue dye during sentinel lymph node biopsy for breast cancerThe American Journal of Surgery, 2001
- Allergic reactions to isosulfan blue during sentinel node biopsy—a common eventSurgery, 2001
- Complementarity of Blue Dye and Isotope in Sentinel Node Localization for Breast Cancer: Univariate and Multivariate Analysis of 966 ProceduresAnnals of Surgical Oncology, 2001
- Adverse Reactions to Isosulfan Blue During Selective Sentinel Lymph Node Dissection in MelanomaAnnals of Surgical Oncology, 2000
- Use of isosulfan blue for identification of lymphatic vessels: experimental and clinical evaluationAmerican Journal of Roentgenology, 1982
- Sensitivity to Patent Blue dye during skin-prick testing and lymphography. A retrospective and prospective study.Radiology, 1981
- Immediate reactions to patent blue dyeContact Dermatitis, 1981
- Experience with 659 consecutive lymphograms in childrenCancer, 1977
- Allergic reaction to patent blue dye in lymphagiographyClinical Radiology, 1971
- Anaphylaxis From Alphazurine 2 G During LymphographyPublished by American Medical Association (AMA) ,1966