How long will I be blue? Prolonged skin staining following sentinel lymph node biopsy using intradermal patent blue dye

Abstract

Background: Blue dye used for sentinel lymph node biopsy (SLNB) in breast cancer patients may cause prolonged skin discoloration at the site of injection. The aim of this study was to assess the duration of such skin discoloration.

Patients and methods: 236 consecutive patients who had undergone breast conserving surgery and SLNB for breast cancer were reviewed prospectively from January 2007 to December 2009.

Results: Of the 236 patients, 2 had undergone bilateral surgery, and 41 had been examined in consecutive yearly reviews. Blue discoloration remained visible at the injection site after 12, 24, and > 36 months in 36.5, 23.6, and 8.6% of the patients, respectively.

Conclusion: The use of patent blue for identification of the sentinel lymph node in patients undergoing breast cancer surgery may result in prolonged discoloration of the skin at the injection site.

Keywords: Axillary staging; Patent blue; Sentinel lymph node biopsy; Skin discoloration.

Figures

Fig. 1

Grade 1 discoloration in a 68-year-old patient with grade 2 invasive ductal carcinoma. 2 years following injection of blue dye, faint skin staining can still be identified.

Fig. 2

Grade 3 discoloration in a 65-year-old patient with grade 2 invasive ductal carcinoma. Marked blue staining is visible 1 week after injection.

Fig. 3

Change in discoloration in 17 patients who were reviewed postoperatively over 2 consecutive years (1st and 2nd year).

Fig. 4

Change in discoloration in 24 patients who were reviewed postoperatively over 2 consecutive years (2nd and 3rd year).