In sentinel lymph node biopsy for breast cancer, which mapping agent combination provides the highest detection rate and lowest false-negative rate compared to either agent alone?

• A Technetium-99m sulfur colloid alone
• B Blue dye alone
• C Indocyanine green alone
• D Combined radiotracer and blue dye ✓

Explanation

The combination of radiotracer (Tc-99m sulfur colloid) and blue dye (isosulfan blue or patent blue) provides the highest sentinel node identification rate (97-99%) and the lowest false-negative rate compared to either agent used alone. Radiotracer alone achieves ~90% identification; blue dye alone is slightly lower. Indocyanine green is emerging as an alternative with comparable results but the dual radiotracer + blue dye combination remains the validated gold standard in guidelines.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.