Good Practice in Combined Use of Dye and mTclabeling Procedures

Depending on the localization of the primary, for instance in breast cancer cases (subcutaneous, centrally in the gland, prefascial), patent blue solution is injected subdermally or peritumorally in a volume of 0.2 ml in subdermal or 4 aliquots of 1,52 ml in deep pertumoral injections (quantities vary in the published literature, and different reasons are given for larger and smaller quantities).

The syringe used must be locked against accidental separation from the needle during injection under pressure, because in such an event the dye will flow over the epidermis and label more or less extensive areas of the skin.

In addition, careful handling is necessary at the site of injection (empty syringe at time of withdraw al, pressure balance within the injection system). Gentle massage at the injection site helps to lessen or avoid reflux of the dye or labeling solution within the superficial parts of the injection channel.

Because it is necessary to be prepared for ana-phylactic reactions after blue dye injection, cortisone and catecholamine solutions should be immediately available and ready to hand.

The injection of 99mTc labeled colloid solution must have been performed 24 hours before the operation.

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