Diffuse skin staining after using isosulfan blue for sentinel lymph node biopsies

A 69-year-old female diagnosed with bilateral invasive lobular breast carcinoma presented to our facility to undergo a bilateral mastectomy with bilateral sentinel lymph node biopsies (SLNB). Pre-operatively, five mL of isosulfan blue dye was injected to the sub-areolar tissue bilaterally and massaged for five minutes just prior to incision. Mild blue staining of the sentinel lymph nodes was noted during the surgery.