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Case Report Open Access


Methylen blue dye related breast skin necrosis requiring mastectomy: Case report

Semih Gorgulu, Zafer Kilbas, Ramazan Yildiz, Erkan Ozturk, Mustafa Oner Mentes, Murat Urkan.

Abstract
Sentinel lymph node (SLN) biopsy is accepted as the gold standard procedure for assessing the status of the axillary lymph node in clinically node-negative breast cancer. The intraoperative blue dye injection is commonly performed to localize the SLN. Systemic allergic complications related to blue dye injection have been well documented, but local adverse effects requiring surgical excision are extremely rare. We report an infrequent case of skin and subcutaneous tissue necrosis following subdermal injection of methylen blue (MB) dye. A 48-year-old female, diagnosed with infiltrating ductal carcinoma, was treated by her initial surgeon with lumpectomy and SLN biopsy. For identification of the SLN, periareolar subdermal injection of 4 ml of 1% MB dye was performed. The patient was seen 10 days following discharge when it was noticed that the periareolar injection sites in the left breast had become necrotic. Since the necrosis invaded the majority of breast, mastectomy had to be performed. Histopathologic examination revealed necrosis of the skin and subcutaneous tissue of the left breast. Although the use of MB dye for SLN biopsy in breast cancer has few systemic reactions, its use has been associated with a number of undesired local complications. Deep parenchymal injections are recommended in order to avoid blue dye-associated skin lesions.

Key words: Blue dye, local complications, sentinel lymph node


 
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REFERENCES
1. Samphao S, Eremin JM, El-Sheemy M, Eremin O. Management of the axilla in women with breast cancer: Current clinical practice and a new selective targeted approach. Ann Surg Oncol 2008;15:1282-96. [DOI via Crossref]    [Pubmed]   
2. Mukherjee A, Kharkwal S, Charak KS. Assessment of the efficacy and safety of methylene blue dye for sentinel lymph node mapping in early breast cancer with clinically negative axilla. Arch Int Surg 2014;4:6-10. [DOI via Crossref]   
3. East JM, Valentine CS, Kanchev E, Blake GO. Sentinel lymph node biopsy for breast cancer using methylene blue dye manifests a short learning curve among experienced surgeons: A prospective tabular cumulative sum (CUSUM) analysis. BMC Surg 2009 27;9:2.
4. Mathelin C, Croce S, Brasse D, Gairard B, Gharbi M, Andriamisandratsoa  N, et al. Methylene blue dye, an accurate dye for sentinel lymph node identification in early breast cancer. Anticancer Res 2009;29:4119-25.
5. Pepels MJ, Vestjens JH, de Boer M, Smidt M, van Diest PJ, Borm GF, et al. Safety of avoiding routine use of axillary dissection in early stage breast cancer: A systematic review. Breast Cancer Res Treat 2011;125:301-13. [DOI via Crossref]    [Pubmed]   
6. Giuliano AE, Kirgan DM, Guenther JM, Morton DL. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg 1994;220:391-8. [DOI via Crossref]    [Pubmed]    [PMC Free Fulltext]   
7. Varghese P, Abdel-Rahman AT, Akberali S, Mostafa A, Gattuso JM, Carpenter R. Methylene blue dye – A safe and effective alternative for sentinel lymph node localization. Breast J 2008;14:61-7. [DOI via Crossref]    [Pubmed]   
8. Thevarajah S, Huston TL, Simmons RM. A  comparison of the adverse reactions associated with isosulfan blue versus methylene blue dye in sentinel lymph node biopsy for breast cancer. Am J Surg 2005;189:236-9. [DOI via Crossref]    [Pubmed]   
9. Montgomery LL, Thorne AC, Van Zee KJ, Fey J, Heerdt AS, Gemignani M, et al. Isosulfan blue dye reactions during sentinel lymph node mapping for breast cancer. Anesth Analg 2002;95:385-8.
10. Stradling B, Aranha G, Gabram S. Adverse skin lesions after methylene blue injections for sentinel lymph node localization. Am J Surg 2002;184:350-2. [DOI via Crossref]   
11. Zakaria S, Hoskin TL, Degnim AC. Safety and technical success of methylene blue dye for lymphatic mapping in breast cancer. Am J Surg 2008;196:228-33. [DOI via Crossref]    [Pubmed]   

How to Cite this Article
Pubmed Style

Gorgulu S, Kilbas Z, Yildiz R, Ozturk E, Mentes MO, Urkan M. Methylen blue dye related breast skin necrosis requiring mastectomy: Case report. Arch Clin Exp Surg. 2016; 5(2): 121-123. doi:10.5455/aces.20140810011530


Web Style

Gorgulu S, Kilbas Z, Yildiz R, Ozturk E, Mentes MO, Urkan M. Methylen blue dye related breast skin necrosis requiring mastectomy: Case report. http://www.acesjournal.org/?mno=165925 [Access: January 19, 2018]. doi:10.5455/aces.20140810011530


AMA (American Medical Association) Style

Gorgulu S, Kilbas Z, Yildiz R, Ozturk E, Mentes MO, Urkan M. Methylen blue dye related breast skin necrosis requiring mastectomy: Case report. Arch Clin Exp Surg. 2016; 5(2): 121-123. doi:10.5455/aces.20140810011530



Vancouver/ICMJE Style

Gorgulu S, Kilbas Z, Yildiz R, Ozturk E, Mentes MO, Urkan M. Methylen blue dye related breast skin necrosis requiring mastectomy: Case report. Arch Clin Exp Surg. (2016), [cited January 19, 2018]; 5(2): 121-123. doi:10.5455/aces.20140810011530



Harvard Style

Gorgulu, S., Kilbas, Z., Yildiz, R., Ozturk, E., Mentes, M. O. & Urkan, M. (2016) Methylen blue dye related breast skin necrosis requiring mastectomy: Case report. Arch Clin Exp Surg, 5 (2), 121-123. doi:10.5455/aces.20140810011530



Turabian Style

Gorgulu, Semih, Zafer Kilbas, Ramazan Yildiz, Erkan Ozturk, Mustafa Oner Mentes, and Murat Urkan. 2016. Methylen blue dye related breast skin necrosis requiring mastectomy: Case report. Archives of Clinical and Experimental Surgery (ACES), 5 (2), 121-123. doi:10.5455/aces.20140810011530



Chicago Style

Gorgulu, Semih, Zafer Kilbas, Ramazan Yildiz, Erkan Ozturk, Mustafa Oner Mentes, and Murat Urkan. "Methylen blue dye related breast skin necrosis requiring mastectomy: Case report." Archives of Clinical and Experimental Surgery (ACES) 5 (2016), 121-123. doi:10.5455/aces.20140810011530



MLA (The Modern Language Association) Style

Gorgulu, Semih, Zafer Kilbas, Ramazan Yildiz, Erkan Ozturk, Mustafa Oner Mentes, and Murat Urkan. "Methylen blue dye related breast skin necrosis requiring mastectomy: Case report." Archives of Clinical and Experimental Surgery (ACES) 5.2 (2016), 121-123. Print. doi:10.5455/aces.20140810011530



APA (American Psychological Association) Style

Gorgulu, S., Kilbas, Z., Yildiz, R., Ozturk, E., Mentes, M. O. & Urkan, M. (2016) Methylen blue dye related breast skin necrosis requiring mastectomy: Case report. Archives of Clinical and Experimental Surgery (ACES), 5 (2), 121-123. doi:10.5455/aces.20140810011530





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