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Updated: Jul 18, 2026

The Application of 1% Methylene Blue Dye As a Single Technique in Breast Cancer Sentinel Node Biopsy

The Application of 1% Methylene Blue Dye As a Single Technique in Breast Cancer Sentinel Node Biopsy

Published on: June 1, 2019

A critique of the sentinel node concept.

G Querci Della Rovere¹, J R Benson

¹The Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK. gquercidellarovere@doctors.org.uk

Breast (Edinburgh, Scotland)

|November 14, 2006

Summary

The sentinel node biopsy concept is questioned, advocating for guided axillary sampling (GAS) instead. Various axillary staging options should be individualized for breast cancer patients.

Area of Science:

Oncology
Surgical Oncology
Breast Cancer Management

Background:

The traditional concept of a single "sentinel node" in breast cancer staging is challenged.
Axillary lymphatic drainage typically involves a group of Level 1 nodes, not a single sentinel node.
Established axillary sampling techniques have a long history of validity in staging.

Purpose of the Study:

To critically evaluate the current standard of care for axillary staging in breast cancer.
To propose alternative terminology and approaches to axillary staging.
To emphasize personalized treatment strategies based on patient and tumor characteristics.

Main Methods:

Review of established oncological principles regarding lymphatic drainage.
Analysis of the historical and current evidence for axillary staging procedures.

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The Application of 1% Methylene Blue Dye As a Single Technique in Breast Cancer Sentinel Node Biopsy

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Sentinel Lymph Node Mapping and Biopsy for Endometrial Cancer at Early Stage with Laparoscopy

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Comparative assessment of sentinel node biopsy (SNB) versus other axillary management options.

Main Results:

The "sentinel node" concept is deemed inaccurate; lymphatic drainage is to a group of nodes.
Sentinel node biopsy (SNB) may not be universally applicable as the standard of care.
Axillary sampling, SNB, axillary dissection, and watchful waiting are all viable options.

Conclusions:

The term "sentinel node biopsy" should potentially be replaced with "guided axillary sampling" (GAS).
Treatment decisions for axillary staging must be individualized, considering patient preferences, clinical condition, and tumor specifics.
A "one-size-fits-all" approach to axillary staging in breast cancer is inappropriate.