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Practice Point
Sentinel node biopsy – Lymphatic mapping #1
Where possible, lymphatic mapping with preoperative lymphoscintigraphy in combination with intraoperative use of the gamma probe and Patent Blue dye should be used to locate the sentinel node(s), noting that the theatre team and anaesthetist must be aware of the potential for Patent Blue dye to cause anaphylaxis.
Where possible, lymphatic mapping with pre-operative lymphoscintigraphy in combination with intraoperative use of the gamma probe and blue dye should be used to locate the sentinel node(s)
Perform SLNB using the dual technique with isotope and blue dye
How this guidance was developed
This practice point was adopted from the CA 2008a guidelines (Australia). The source recommendation was based on a systematic review of the evidence conducted to July 2007 and was not graded by the source guideline authors. The recommendation in the NICE 2018 (UK) guidelines is noted that supports use of the dual technique. This recommendation was based on a review of the evidence in July 2008. Importance of awareness of the potential anaphylaxis risk with Patent Blue dye by the theatre team and anaesthetist was specifically added. The CA 2008 guidelines further indicate that, in the event of an adverse reaction, agreed protocols should be in place. The source recommendation was accepted as a practice point, given the time elapsed since the systematic review.
Sentinel node biopsy – Lymphatic mapping #1
Practice Point
Where possible, lymphatic mapping with preoperative lymphoscintigraphy in combination with intraoperative use of the gamma probe and Patent Blue dye should be used to locate the sentinel node(s), noting that the theatre team and anaesthetist must be aware of the potential for Patent Blue dye to cause anaphylaxis.
Principles in action
Safe and quality care
This practice point was adopted from the CA 2008a guidelines (Australia). The source recommendation was based on a systematic review of the evidence conducted to July 2007 and was not graded by the source guideline authors. The recommendation in the NICE 2018 (UK) guidelines is noted that supports use of the dual technique. This recommendation was based on a review of the evidence in July 2008. Importance of awareness of the potential anaphylaxis risk with Patent Blue dye by the theatre team and anaesthetist was specifically added. The CA 2008 guidelines further indicate that, in the event of an adverse reaction, agreed protocols should be in place. The source recommendation was accepted as a practice point, given the time elapsed since the systematic review.