Indocyanine green fluorescence method for sentinel lymph node biopsy in breast cancer
Background/Objective: Breast biopsy and analysis of sentinel lymph nodes (SLNs) accurately predict tumor status in the affected basin and help in avoiding unnecessary axillary lymph node dissection, which is associated with remarkable morbidity risk. Blue dye and radioisotope are the most widely use...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-12-01
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| Series: | Asian Journal of Surgery |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1015958420300452 |
| _version_ | 1818391512110596096 |
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| author | Joseph Lin Li-Sheng Lin Dar-Ren Chen Kuo-Juei Lin Yu-Fen Wang Yu-Jun Chang |
| author_facet | Joseph Lin Li-Sheng Lin Dar-Ren Chen Kuo-Juei Lin Yu-Fen Wang Yu-Jun Chang |
| author_sort | Joseph Lin |
| collection | DOAJ |
| description | Background/Objective: Breast biopsy and analysis of sentinel lymph nodes (SLNs) accurately predict tumor status in the affected basin and help in avoiding unnecessary axillary lymph node dissection, which is associated with remarkable morbidity risk. Blue dye and radioisotope are the most widely used mapping agents, but non-radioactive tracers of comparable accuracy warrant further investigation. This study aimed to investigate utilization of indocyanine green (ICG) fluorescence in sentinel node localization compared with blue dye and to assess the incremental value of ICG. Methods: A total of 39 consecutive patients underwent sentinel lymph node biopsy (SLNB) (40 cases: 38 unilateral and 1 bilateral) with combined blue dye and ICG for localization. The obtained fluorescence images of the lymphatic system were investigated. Results: All 84 lymph nodes removed in 40 procedures were identified by ICG, but only 37 were identified by blue dye. The ICG method identified an average of 2.1 SLNs in 39 of 40 cases with a detection rate of 97.5%, but only 0.93 SLN per case with blue dye. Subcutaneous lymphatic channel patterns were also detected by fluorescent imaging in 37 procedures, which all revealed lymphatic drainage toward the axilla except in one case with internal mammary pathway. Conclusion: This study demonstrated the accuracy and safety of ICG for SLNB and its superiority to blue dye method in SLN localization. Therefore, ICG fluorescence method is safe and effective addition in breast clinical settings, wherein blue dye alone is used. |
| first_indexed | 2024-12-14T05:14:42Z |
| format | Article |
| id | doaj.art-c5160b41de534f6798132a7eb4cfbc52 |
| institution | Directory Open Access Journal |
| issn | 1015-9584 |
| language | English |
| last_indexed | 2024-12-14T05:14:42Z |
| publishDate | 2020-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Surgery |
| spelling | doaj.art-c5160b41de534f6798132a7eb4cfbc522022-12-21T23:15:52ZengElsevierAsian Journal of Surgery1015-95842020-12-01431211491153Indocyanine green fluorescence method for sentinel lymph node biopsy in breast cancerJoseph Lin0Li-Sheng Lin1Dar-Ren Chen2Kuo-Juei Lin3Yu-Fen Wang4Yu-Jun Chang5Comprehensive Breast Cancer Center, Changhua Christian Hospital, 135, Nanhsiao Street, Changhua, 50006, TaiwanDepartment of Breast Surgery, The Affiliated Hospital (Group) of Putian University, Putian, Fujian, 351100, ChinaComprehensive Breast Cancer Center, Changhua Christian Hospital, 135, Nanhsiao Street, Changhua, 50006, Taiwan; Cancer Research Center, Changhua Christian Hospital, 135, Nanhsiao Street, Changhua, 50006, Taiwan; School of Medicine, Chung Shan Medical University, 110, Sec. 1, Jianguo N. Rd., Taichung, 40201, Taiwan; Corresponding author. Comprehensive Breast Cancer Center, Changhua Christian Hospital, 135, Nanhsiao Street, Changhua, 50006, Taiwan.Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, 82445, TaiwanCancer Research Center, Changhua Christian Hospital, 135, Nanhsiao Street, Changhua, 50006, TaiwanEpidemiology and Biostatistics Center, Changhua Christian Hospital, 135, Nanhsiao Street, Changhua, 50006, TaiwanBackground/Objective: Breast biopsy and analysis of sentinel lymph nodes (SLNs) accurately predict tumor status in the affected basin and help in avoiding unnecessary axillary lymph node dissection, which is associated with remarkable morbidity risk. Blue dye and radioisotope are the most widely used mapping agents, but non-radioactive tracers of comparable accuracy warrant further investigation. This study aimed to investigate utilization of indocyanine green (ICG) fluorescence in sentinel node localization compared with blue dye and to assess the incremental value of ICG. Methods: A total of 39 consecutive patients underwent sentinel lymph node biopsy (SLNB) (40 cases: 38 unilateral and 1 bilateral) with combined blue dye and ICG for localization. The obtained fluorescence images of the lymphatic system were investigated. Results: All 84 lymph nodes removed in 40 procedures were identified by ICG, but only 37 were identified by blue dye. The ICG method identified an average of 2.1 SLNs in 39 of 40 cases with a detection rate of 97.5%, but only 0.93 SLN per case with blue dye. Subcutaneous lymphatic channel patterns were also detected by fluorescent imaging in 37 procedures, which all revealed lymphatic drainage toward the axilla except in one case with internal mammary pathway. Conclusion: This study demonstrated the accuracy and safety of ICG for SLNB and its superiority to blue dye method in SLN localization. Therefore, ICG fluorescence method is safe and effective addition in breast clinical settings, wherein blue dye alone is used.http://www.sciencedirect.com/science/article/pii/S1015958420300452Breast neoplasmsIndocyanine greenBlue dyeSentinel lymph node biopsy |
| spellingShingle | Joseph Lin Li-Sheng Lin Dar-Ren Chen Kuo-Juei Lin Yu-Fen Wang Yu-Jun Chang Indocyanine green fluorescence method for sentinel lymph node biopsy in breast cancer Asian Journal of Surgery Breast neoplasms Indocyanine green Blue dye Sentinel lymph node biopsy |
| title | Indocyanine green fluorescence method for sentinel lymph node biopsy in breast cancer |
| title_full | Indocyanine green fluorescence method for sentinel lymph node biopsy in breast cancer |
| title_fullStr | Indocyanine green fluorescence method for sentinel lymph node biopsy in breast cancer |
| title_full_unstemmed | Indocyanine green fluorescence method for sentinel lymph node biopsy in breast cancer |
| title_short | Indocyanine green fluorescence method for sentinel lymph node biopsy in breast cancer |
| title_sort | indocyanine green fluorescence method for sentinel lymph node biopsy in breast cancer |
| topic | Breast neoplasms Indocyanine green Blue dye Sentinel lymph node biopsy |
| url | http://www.sciencedirect.com/science/article/pii/S1015958420300452 |
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