Clin Surg | Volume 3, Issue 1 | Research Article | Open Access

Anaphylactic Reactions to Isosulfan Blue Dye during Sentinel Lymph Node Biopsy for Breast Cancer

Tao Wang1#, De-bin Xu2# and Zhen Liao3*

1Departmentsof Otolaryngology-Head & Neck Surgery, Sun Yat-sen University, China
2Departments of Thyroid and Neck Surgery, Nan Chang University, China
3Department of Operation Theater Services, Sun Yat-Sen University Cancer Center, China
#Both authors contributed equally

*Correspondance to: Zhen Liao 

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Background: The sentinel lymph node biopsy is an alternative to axillary dissection for many breast cancer patients. Cases of anaphylactic reaction to the isosulfan blue dye used during sentinel lymph node biopsy have recently been reported. A retrospective study the incidence and severity of adverse reactions to isosulfan blue dye, we evaluated the incidence of severe anaphylactic reactions to isosulfan blue dye during the performance of sentinel lymph node biopsy for breast cancer at our institution.Methods: A retrospective chart review study was enrolled consecutive 1456 patients for breast cancer performed at our institution. Sentinel lymph node biopsy was performed using both isosulfan blue dye and technetium-99m sulfur colloid. Cases of anaphylaxis were reviewed in detail.Results: Overall, 12(0.8%) of the 1456 patients had severe anaphylactic reactions. All 12 patients experienced cardiovascular collapse (profound hypotension and tachycardia) and skin reactions and patients required admission to an intensive care unit bed or equivalent setting for postoperative monitoring. No deaths or permanent disability occurred. Conclusions: Prompt recognition and aggressive treatment of anaphylactic reactions to isosulfan blue are critical to prevent an adverse outcome. Lymphatic mapping with blue dye should be performed in a setting where personnel are trained to recognize and treat anaphylaxis


Sentinel lymph node; Biopsy; Anaphylaxis


Wang T, Xu D-B, Liao Z. Anaphylactic Reactions to Isosulfan Blue Dye during Sentinel Lymph Node Biopsy for Breast Cancer. Clin Surg. 2018; 3: 2104.

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