A Comparison of Indocyanine Green Fluorescence Imaging Plus Blue Dye and Blue Dye Alone for Sentinel Node Navigation Surgery in Breast Cancer Patients
- 11 July 2012
- journal article
- research article
- Published by Springer Science and Business Media LLC in Annals of Surgical Oncology
- Vol. 19 (13), 4112-4116
- https://doi.org/10.1245/s10434-012-2478-0
Abstract
To evaluate two methods of sentinel node navigation surgery (SNNS) using blue dye with and without indocyanine green (ICG) fluorescence imaging (FI) to determine the usefulness of combined ICG and blue dye. Between 2005 and 2010, a total of 501 patients underwent SNNS in our hospital. Detection of sentinel lymph node (SLN) was performed with sulfan blue (SB) alone until 2008 and with a combination of SB and ICG-FI since 2009. ICG 5 mg and SB 15 mg were injected in the subareolar region, and FI was obtained by a fluorescence imaging device. We attempted to identify SLNs in 393 patients by SB alone and in 108 patients by a combination of SB and FI. The mean number of SLNs detected was 1.6 (0–5) for SB alone and 2.2 (1–6) for the combination method. The SLN identification rate was 95.7 % for SB alone and 100 % for the combination method so that the combination was significantly superior to SB in terms of the identification rate (p = 0.0037). In patients who received the combination method, detection of SLN was made through only SB in 1 patient, only ICG in 8 patients, and both in 99 patients. Lymph node metastasis was found in 56 patients with SB alone and in 16 patients with the combination method. Recurrence of an axillary node was observed in 3 patients (0.8 %) with SB alone and in no patients with the combination method. ICG-FI is a useful method and is especially recommended in cases where no radiotracers are available.Keywords
This publication has 20 references indexed in Scilit:
- Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trialThe Lancet Oncology, 2010
- Polypoidal choroidal vasculopathy and late geographic hyperfluorescence on indocyanine green angiographyBritish Journal of Ophthalmology, 2009
- Intraoperative identification of sentinel lymph nodes by near-infrared fluorescence imaging in patients with breast cancerThe American Journal of Surgery, 2008
- Progress and promise: highlights of the international expert consensus on the primary therapy of early breast cancer 2007Annals of Oncology, 2007
- Guidelines to assure quality in breast cancer surgeryEuropean Journal of Surgical Oncology, 2005
- Modifications of the learning curve guidelines for breast cancer sentinel node biopsyEuropean Journal of Surgical Oncology, 2005
- Preoperative assessment of liver functionSurgical Clinics of North America, 2004
- How many cases are enough for accreditation in sentinel lymph node biopsy in breast cancer?The American Journal of Surgery, 2003
- The Sentinel Node in Breast Cancer — A Multicenter Validation StudyNew England Journal of Medicine, 1998
- Guidelines for Sentinel Node Biopsy and Lymphatic Mapping of Patients With Breast CancerAnnals of Surgery, 1998