Isosulfan blue dye reactions during sentinel lymph node mapping for breast cancer Journal Article


Authors: Montgomery, L. L.; Thorne, A. C.; Van Zee, K. J.; Fey, J.; Heerdt, A. S.; Gemignani, M.; Port, E.; Petrek, J.; Cody, H. S. 3rd; Borgen, P. I.
Article Title: Isosulfan blue dye reactions during sentinel lymph node mapping for breast cancer
Abstract: In the United States, identification of the sentinel lymph node (SLN) requires the use of 99mTc-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.
Keywords: clinical article; retrospective studies; lymph node metastasis; isosulfan blue; lymphoscintigraphy; rosaniline dyes; sentinel lymph node biopsy; breast cancer; breast neoplasms; drug hypersensitivity; pruritus; rash; hypotension; cross reaction; databases, factual; anaphylaxis; urticaria; bronchospasm; drug eruptions; anesthesia; diphenhydramine; wheezing; lymphography; coloring agents; cross reactions; histamine h1 antagonists; humans; human; female; priority journal; article
Journal Title: Anesthesia and Analgesia
Volume: 95
Issue: 2
ISSN: 0003-2999
Publisher: Lippincott Williams & Wilkins  
Date Published: 2002-08-01
Start Page: 385
End Page: 388
Language: English
PUBMED: 12145056
PROVIDER: scopus
DOI: 10.1213/00000539-200208000-00026
DOI/URL:
Notes: Export Date: 14 November 2014 -- Source: Scopus
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MSK Authors
  1. Alisa C Thorne
    16 Thorne
  2. Jeanne Ann Petrek
    91 Petrek
  3. Kimberly J Van Zee
    293 Van Zee
  4. Hiram S Cody III
    242 Cody
  5. Mary L Gemignani
    218 Gemignani
  6. Elisa Port
    46 Port
  7. Alexandra S Heerdt
    110 Heerdt
  8. Patrick I Borgen
    253 Borgen
  9. Jane Fey
    66 Fey