[Intraoperative injection of technetium-99m-dextran 500 for the identification of sentinel lymph node in breast cancer]
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Updated: Jun 4, 2026
The Application of 1% Methylene Blue Dye As a Single Technique in Breast Cancer Sentinel Node Biopsy
Published on: June 1, 2019
Gerson Jacob Delazeri1, Nilton Leite Xavier, Carlos Henrique Menke
1Programa de Pós-Graduação em Medicina - Ciências Médicas, Universidade Federal do Rio Grande do Sul – UFRGS – Porto Alegre (RS), Brasil. gersonjacob@gmail.com
Purpose:
to determine the efficacy of intraoperative injection of Dextran-500-99m-technetium (Tc) for the identification of the sentinel lymph node (SLN) in breast cancer and analyze time to label the SLN in the axillary region.
Methods:
a prospective study between April 2008 and June 2009, which included 74 sentinel lymph node biopsies (SLNB) in patients with breast cancer in stages T1N0 and T2N0. After induction of anesthesia, 0.5 to 1.5 mCi of Dextran-500-99m-Tc filtered 0.22 µm in a volume of 5 mL was injected intraoperative using the subareolar technique for SLNB. After labeling with the radioisotope, 2 mL of patent blue was injected. The time elapsed between injection and the axillary hot spot, the in vivo and ex vivo counts of the hottest nodes, the background count, and the number of SLN identified were documented. Data were analyzed using descriptive statistics with SPSS program, version 18.
Results:
we identified the SLN in 100% of cases. The rate of SLN identification with the probe was 98% (73/74 cases). In one case (1.35%) the SLN was labeled only with the blue dye. The mean dose of radioisotope injected was 0.97 ± 0.22 mCi. The average time to label the SLN was 10.7 minutes (± 5.7 min). We identified on average of 1.66 SLN labeled with the radioisotope.
Conclusion:
the procedure for SLN identification with an intraoperative injection of the radioisotope is oncologically safe and comfortable for the patient, providing agility to the surgical team.
