Meme Kanseri Cerrahisinde Metilen Mavisi Düşündüğümüz Kadar Masum Mu?

Yıl 2021, Cilt: 3 Sayı: 1, 40 - 43, 01.03.2021

Fazilet Erözgen , Alp Ömer Cantürk , Türkan İkizceli

https://doi.org/10.38175/phnx.819713

Öz

Meme kanseri cerrahisinde aksiller durumu belirlemekte metilen mavisi dünyada yaygın olarak kullanılan güvenli bir yöntemdir. Aksilla değerlendirilirken metilen mavisi işaretlemesi sonrası sentinel lenf nodu incelenmesi önerilen bir yaklaşımdır. Metilen mavisinin meme cerrahisinde aksiller durumu tespit etmede hem ucuz hem de efektif bir yöntemdir. Az da olsa risk içermektedir. Hatta bazı durumlarda tekrarlayan cerrahi girişimler gerektirecek ciddi sonuçlara yol açabilmektedir. Bazen ciddi nekrozlara bazen ise yara yerinde eritem ve enfeksiyona yol açabilmektedir. Bu yönüyle metilen mavisinin sadece mortaliteye yol açmayan komplikasyonlara neden olmakta kalmayıp, bazen de kozmetik kötü sonuçlara yol açabilmektedir.
Haseki Eğitim ve Araştırma Hastanesi’nde 2015-2020 yılları arasında meme kanseri cerrahisi operasyonu geçirmiş olan 682 hastamız derlendi. Bu operayonların 372’sinde sentinel lenf nodu örneklemesi gerekmiştir. Bu yazıda aksiller sentinel lenf nodu örneklemesi esnasında kullanılan metilen mavisinin sonucunda gelişmiş 2 adet komplikasyonu sunuldu.

Anahtar Kelimeler

Metilen mavisi, Komplikasyon, Meme kanseri cerrahisi, Sentinel lenf nodu

Destekleyen Kurum

yok

Proje Numarası

yok

Teşekkür

Dr Ahmet Kocakuşak

Is Methylene Blue as Innocent as We Think in Breast Cancer Surgery?

Öz

Methylene blue is a widely used and safe method in the world to determine the axillary region in breast cancer surgery. When evaluating the axilla, it is recommended to examine the sentinel lymph node after methylene blue marking. Methylene blue is an inexpensive and effective method for detecting axillary regions in breast surgery. It contains less risk. In some cases, it can lead to serious consequences that will require repetitive surgical interventions. It can sometimes lead to severe necrosis and sometimes to erythema and infection. In this respect, methylene blue not only causes complications that do not cause mortality, but can sometimes lead to poor cosmetic results.
682 patients who underwent breast cancer surgery, Haseki Training and Research Hospital between 2015-2020 were compiled. Sentinel lymph node sampling was required in 372 of these patients. In this article, two complications developed as a result of methylene blue used during axillary sentinel lymph node sampling are presented.

Anahtar Kelimeler

Methylene blue, Complication, Breast cancer surgery, Sentinel lymph node, Side effect

Proje Numarası

yok

Kaynakça

• Tanis PJ, Nieweg OE, Olmos RAV, Rutgers EJ, Kroon BR. History of sentinel lymph node and validation of the technique. Breast Cancer Res. 2001;3:109-112.
• Chen SL, Iddings DM, Scherri RP Bilchik AJ. Lymphatic mapping and sentinel node analysis: current concepts and applications. CA Cancer J Clin. 2006;56:293-309.
• Kim T, Giuliano AE, Lyman GH. Lymphatic mapping and sentinel lymph node biopsy in early-stage breast carcinoma. A meta-analysis. Cancer. 2006;106:4-16.
• Parvaiz MA, Isgar B. Anaphylaxis, and blue urticaria associated with patent blue V injection. Anesthesia. 2012;67:1275-1276.
• Brenet O, Lalourcey L, Queinnec M, Dupoiron D, Jayr C, Rosay H, et al. Hypersensitivity reactions to patent Blue V in breast cancer surgery: a prospective multicentre study. Acta Anesthesiol Scand. 2013;57:106-111.
• Newman EA, Newman LA. Lymphatic mapping techniques and Sentinel lymph node biopsy in breast cancer. Surg Clin N Am. 2007;87:353-364.
• 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(1):61-67.
• Fisher B, Wolmark N, Bauer M, Redmond C, Gebhardt M. The accuracy of clinical nodal staging and of limited axillary dissection as a determinant of histologic nodal status in carcinoma of the breast. Surg Gynecol Obstet. 1981;152:765–772.
• Albo D, Wayne JD, Hunt KK, Rahlfs TF, Singletary SE, Ames FC, et al. Anaphylactic reactions to isosulfan blue dye during sentinel lymph node biopsy for breast cancer. Am J Surg 2001;182:393-398.
• Stradling BS, Aranha G, Gabram S. Adverse skin lesions after methylene blue injections for sentinel lymph node localization. Am J Surg. 2002;184:350-352.