Abstract
Background
Although blue dye is routinely used for lymphatic mapping, it is not used for lymphatic
mapping in pregnancy-associated breast cancer, because of concern of fetal risk.
Methods
To investigate the safety of blue dye for lymphatic mapping in pregnant women, the
pharmacokinetics of methylene blue dye were examined in 10 nonpregnant women, and
the results were extrapolated to estimate maximal fetal exposure to the dye.
Results
Plasma and urine measurements indicated that the dye quickly distributed from the
breast injection site to the circulation, with 32% of the total dose excreted in urine
within 48 hours. Combined with existing data on organ distribution of methylene blue,
the estimated maximal dose to the fetus is 0.25 mg (5% of the administered dose),
likely further reduced by other physiologic factors related to pregnancy.
Conclusions
The analysis suggests that methylene blue dye can be used for lymphatic mapping in
pregnancy-associated breast cancer with minimal fetal risk.
Keywords
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Article info
Publication history
Received in revised form:
March 31,
2009
Received:
February 3,
2009
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
