Could a Sentinel Lymph Node Biopsy Be Performed with Isolated Methylene Blue Injection in a Patient with a History of Skin-Sparing Mastectomy and Prosthetic Reconstruction

Abstract

Evaluation of lymphatic spread in early stage breast cancer without clinical and radiological evidence of metastasis can be performed by sentinel lymph node biopsy (SLNB). However, controversies about performing the SLNB in patients who have a history of major breast or axillary region surgery keep going. This case report presents the outcomes of a SLNB performed on a 42-year-old woman who had been previously treated with bilateral nipple and skin-sparing mastectomy and breast reconstruction with areolar complex transfer and silicone breast implants. 0.5% diluted methylene blue solution was injected intradermally as a marker. SLNB is an inexpensive and effective method for adequate axillary evaluation in cases with previous mastectomy history. Intradermal injection of 0.5% diluted methylene blue could reduce the risk of skin necrosis and breast prosthesis rupture.