In a clinically node-negative patient with early breast cancer undergoing wide local excision, which combination correctly describes the standard dual-localisation technique for sentinel lymph node biopsy?

• A Methylene blue dye combined with indocyanine green fluorescence
• B Patent blue dye combined with intraoperative frozen section of all level I nodes
• C Technetium-99m sulphur colloid combined with preoperative axillary ultrasound
• D Isosulfan blue dye combined with technetium-99m sulphur colloid ✓

Explanation

The standard dual mapping technique combines a blue dye (isosulfan blue or patent blue) injected peritumourally or subdermally with a radioactive colloid tracer such as technetium-99m sulphur colloid, identified with a gamma probe. Dual mapping raises identification rates above either agent alone and reduces false negatives. Indocyanine green is an emerging alternative rather than the established standard. Frozen section of all level I nodes defeats the purpose of the staged, minimally invasive axillary approach.

Reference: Sabiston Textbook of Surgery, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.