The findings of a study suggest that using axillary reverse mapping (ARM) with methylene blue plus fluorescent dye indocyanine green (ICG) results in an improved visualization rate of lymph nodes in patients with invasive breast cancer. The findings were reported in the Journal of Oncology.

Between January 2016 and June 2017, researchers analyzed 46 patients with stage 1 to 4 primary breast cancer who underwent radical mastectomy. Patients who received preoperative radiotherapy/chemotherapy or had bilateral disease were excluded. ARM occurred pre-surgery, and study participants either received methylene blue alone (control group; n=22) or methylene blue plus ICG (n=24).

The overall visualization rate in the study was 80.4%, and the visualization rate was markedly higher in the methylene blue plus ICG group (91.67%) compared with the methylene blue alone group (63.64%; P=.032). The results demonstrated that methylene blue plus ICG presented especially high identification rates in patients with more invasive breast cancer. The authors concluded that this use of methylene blue plus ICG during ARM is feasible for this patient population.

Reference: Wang H, Wu B, Wang Z. Application of fluorescence dye in combination with methylene blue for axillary reverse mapping in patients with modified radical mastectomy for breast cancer. J Oncol. 2022;2022:2305542. doi:10.1155/2022/2305542