Sentinel node biopsy: Dyes for identification

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Published: 23 Nov 2016
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Dr Michael Douek - Guy’s and St Thomas’ Hospital, London, UK

Dr Douek speaks with ecancertv at NCRI 2016 about the use of dyes in sentinel node biopsy.

He describes how, considering the risk of allergic response or permanent staining, combined blue dye and radio-isotope remains the best means of identifying diseased tissue.

We looked at the value of using blue dye in conjunction with the combined technique for sentinel node biopsy. Blue dye is, of course, standard of care, we all use the combined technique for sentinel node biopsy but increasingly centres have stopped using blue dye because of the fact that it causes adverse events including the rare occurrence of an allergic reaction, anaphylaxis, but also the tattooing of the skin. So we looked at whether that was a good thing to do or whether that was not going to produce the same sensitivity of the original technique.

Who else is using this technique?

I work with a number of surgeons, we all use the combined technique but I then analysed the identification rate using the results on the radioisotope alone and the blue dye alone. What I found was that the identification rate for the combined technique was 98.8% in our hands and it was 97.5% with the radioisotope alone and it was 92.5% with the blue dye alone.

What does this tell us?

What it tells us is that the combined technique has got a very high identification rate, that using a radioisotope alone can also produce high identification rates in good hands but using blue dye alone is probably not a good idea.