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Updated: Oct 4, 2025
The Application of 1% Methylene Blue Dye As a Single Technique in Breast Cancer Sentinel Node Biopsy
Published on: June 1, 2019
Single shot lymphoscintigraphy in breast cancer: Effective single tracer sentinel node detection protocol with
Janice N Thai1, Michael Shamis1, Ami Gokli1
1Staten Island University Hospital, Northwell Health, Staten Island, NY, United States of America.
Purpose:
Variation in protocols for axillary sentinel lymph node (SLN) mapping exists. We strive to evaluate the effectiveness of reduction in number of injections on reducing procedural pain, while maintaining nodal detection.
Methods:
Over 7 years, the number of periareolar injections performed was reduced stepwise from 4 to 1. This was analyzed for SLN detection and patients' subjective perceived pain.
Results:
828 patients with invasive breast cancer who underwent SLN mapping were included. Laterality of breast injection site included 326 (39.4%) in the right breast, 354 (42.8%) in the left breast and 148 (17.9%) in bilateral breasts. In patients who had 4 injection sites in a unilateral breast (n = 143), the reported pain score was 4.3 ± 2.4. Patients with 3 injections (n = 163), 2 injections (n = 163) and 1 injection (n = 211) in a breast reported pain scores of 3.4 ± 2.4, 3.2 ± 2.2, and 2.9 ± 2.6, respectively. In patients who had bilateral sentinel node procedures, those with 4 injections in each breast for a total of 8 injections (n = 37) reported a pain score of 5.7 ± 2.4. Patients with 3 (n = 51), 2 (n = 31) and 1 (n = 39) injection(s) in each breast reported perceived pain of 4.8 ± 2.8, 3.7 ± 2.7 and 3.5 ± 1.9, respectively. Incremental decreased pain scores were achieved with decreasing number of injections (p < 0.001). Nodal detection was maintained.
Conclusion:
A single periareolar subdermal injection site reduces periprocedural pain while maintaining nodal detection.
