• Régis Resende Paulinelli, Ruffo Freitas-Junior, Rosemar Macedo de Souza Rahal, Luis Fernando de Pádua Oliveira, Maria Helena Tavares Vilela, Marise Amaral Rebouças Moreira, Katyane Larissa Alves, Marina Berquó Peleja, and Tatiane Coelho Capel de Resende.
• MD, PhD, Mastology Program, Department of Gynecology and Obstetrics, Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil.
• Rev Assoc Med Bras (1992). 2017 Feb 1; 63 (2): 118-123.

Introduction:Methylene blue is more widely available and less expensive than patent blue, with an apparently lower risk of anaphylaxis.Objective:The two dyes were compared regarding detection of the sentinel lymph node (SLN).Method:A prospective, randomized trial involved 142 patients with invasive breast carcinoma. Sixty-nine (49.3%) assigned to patent blue (group A) and 71 (50.70%) to methylene blue (group B). Thirty-five patients (25.0%) were clinical stage III or IV; 55 (38.7%) had axillary lymph nodes affected; and 69 (49.3%) underwent neoadjuvant chemotherapy. Two patients were excluded because the dye type was not recorded.Results:Patients and tumor characteristics were similar in both groups. SLNs were identified in 47 women (68.1%) in group A and 43 (60.6%) in group B (p=0.35). SLNs were affected in 22 cases (51.2%) in group A and 21 (48.8%) in group B (p=0.62). The SLN was the only node affected in 12 cases (54.5%) in group A and six (33.3%) in group B (p=0.18). The time and degree of difficulty involved in identifying the SLN were similar in both groups. There were no complications or allergies.Conclusion:Methylene blue performed as well as patent blue in identifying the SLN in breast cancer patients.

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