Indocyanine Green Detects Sentinel Lymph Nodes in Early Breast Cancer

Overview

Journal J Int Med Res

Publisher Sage Publications

Specialty General Medicine

Date 2017 Apr 19

PMID 28415938

Citations 20

Authors

Jun Liu

Linping Huang

Ning Wang

Ping Chen

Affiliations

Soon will be listed here.

Abstract

Objective To explore the clinical value of indocyanine green (ICG) for the fluorescence-guided detection of sentinel lymph nodes (SLNs) during sentinel lymph node biopsy (SLNB) in patients with early breast cancer. Methods This retrospective study included female patients with breast cancer. Patients were administered methylene blue and ICG using standard techniques. All SLNs that were collected during surgery were submitted for pathological examination. SLNs were defined as those that were either fluorescent, blue, fluorescent and blue or palpably suspicious. Surgical complications, axillary recurrence, distant metastasis and overall survival rates were observed postoperatively. Results A total of 60 patients were enrolled in the study. The fluorescence detection rate of SLNs was 100% ( n = 177), with a mean of 2.95 SLNs per patient. The methylene blue staining rate was 88.3% ( n = 106), with a mean of 1.77 SLNs per patient. Pathological assessment of intraoperative frozen specimens revealed SLN metastases in 10 patients, who immediately underwent axillary lymph node dissection. No patient had axillary recurrence or distant metastases, with a survival rate of 100%. Patients who underwent SLNB showed good appearance in the axillary wound, with no limited shoulder joint abduction and upper limb oedema. Conclusion Fluorescence-guided SLNB has several advantages and is suitable for clinical application.

Citing Articles

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References

Goyal A, Newcombe R, Chhabra A, Mansel R . Factors affecting failed localisation and false-negative rates of sentinel node biopsy in breast cancer--results of the ALMANAC validation phase. Breast Cancer Res Treat. 2006; 99(2):203-8. DOI: 10.1007/s10549-006-9192-1. View

Kitai T, Inomoto T, Miwa M, Shikayama T . Fluorescence navigation with indocyanine green for detecting sentinel lymph nodes in breast cancer. Breast Cancer. 2005; 12(3):211-5. DOI: 10.2325/jbcs.12.211. View

Goldhirsch A, Ingle J, Gelber R, Coates A, Thurlimann B, Senn H . Thresholds for therapies: highlights of the St Gallen International Expert Consensus on the primary therapy of early breast cancer 2009. Ann Oncol. 2009; 20(8):1319-29. PMC: 2720818. DOI: 10.1093/annonc/mdp322. View

Hirche C, Murawa D, Mohr Z, Kneif S, Hunerbein M . ICG fluorescence-guided sentinel node biopsy for axillary nodal staging in breast cancer. Breast Cancer Res Treat. 2010; 121(2):373-8. DOI: 10.1007/s10549-010-0760-z. View

Wishart G, Loh S, Jones L, Benson J . A feasibility study (ICG-10) of indocyanine green (ICG) fluorescence mapping for sentinel lymph node detection in early breast cancer. Eur J Surg Oncol. 2012; 38(8):651-6. DOI: 10.1016/j.ejso.2012.05.007. View

Tagaya N, Yamazaki R, Nakagawa A, Abe A, Hamada K, Kubota K . Intraoperative identification of sentinel lymph nodes by near-infrared fluorescence imaging in patients with breast cancer. Am J Surg. 2008; 195(6):850-3. DOI: 10.1016/j.amjsurg.2007.02.032. View

Hojo T, Nagao T, Kikuyama M, Akashi S, Kinoshita T . Evaluation of sentinel node biopsy by combined fluorescent and dye method and lymph flow for breast cancer. Breast. 2010; 19(3):210-3. DOI: 10.1016/j.breast.2010.01.014. View

Tummers Q, Hoogstins C, Peters A, de Kroon C, Trimbos J, van de Velde C . The Value of Intraoperative Near-Infrared Fluorescence Imaging Based on Enhanced Permeability and Retention of Indocyanine Green: Feasibility and False-Positives in Ovarian Cancer. PLoS One. 2015; 10(6):e0129766. PMC: 4482512. DOI: 10.1371/journal.pone.0129766. View

Schaafsma B, Mieog J, Hutteman M, van der Vorst J, Kuppen P, Lowik C . The clinical use of indocyanine green as a near-infrared fluorescent contrast agent for image-guided oncologic surgery. J Surg Oncol. 2011; 104(3):323-32. PMC: 3144993. DOI: 10.1002/jso.21943. View

10.

Morton D, Wen D, Wong J, Economou J, Cagle L, Storm F . Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg. 1992; 127(4):392-9. DOI: 10.1001/archsurg.1992.01420040034005. View

11.

Namikawa K, Tsutsumida A, Tanaka R, Kato J, Yamazaki N . Limitation of indocyanine green fluorescence in identifying sentinel lymph node prior to skin incision in cutaneous melanoma. Int J Clin Oncol. 2013; 19(1):198-203. DOI: 10.1007/s10147-013-0524-y. View

12.

Sugie T, Sawada T, Tagaya N, Kinoshita T, Yamagami K, Suwa H . Comparison of the indocyanine green fluorescence and blue dye methods in detection of sentinel lymph nodes in early-stage breast cancer. Ann Surg Oncol. 2013; 20(7):2213-8. DOI: 10.1245/s10434-013-2890-0. View

13.

Mieog J, Troyan S, Hutteman M, Donohoe K, van der Vorst J, Stockdale A . Toward optimization of imaging system and lymphatic tracer for near-infrared fluorescent sentinel lymph node mapping in breast cancer. Ann Surg Oncol. 2011; 18(9):2483-91. PMC: 3139732. DOI: 10.1245/s10434-011-1566-x. View

14.

Ciatto S, Brancato B, Risso G, Ambrogetti D, Bulgaresi P, Maddau C . Accuracy of fine needle aspiration cytology (FNAC) of axillary lymph nodes as a triage test in breast cancer staging. Breast Cancer Res Treat. 2006; 103(1):85-91. DOI: 10.1007/s10549-006-9355-0. View

15.

Torre L, Bray F, Siegel R, Ferlay J, Lortet-Tieulent J, Jemal A . Global cancer statistics, 2012. CA Cancer J Clin. 2015; 65(2):87-108. DOI: 10.3322/caac.21262. View

16.

Polom K, Murawa D, Rho Y, Nowaczyk P, Hunerbein M, Murawa P . Current trends and emerging future of indocyanine green usage in surgery and oncology: a literature review. Cancer. 2011; 117(21):4812-22. DOI: 10.1002/cncr.26087. View

17.

Wang Y, Dong H, Wu H, Zhang L, Yuan K, Chen H . Improved false negative rate of axillary status using sentinel lymph node biopsy and ultrasound-suspicious lymph node sampling in patients with early breast cancer. BMC Cancer. 2015; 15:382. PMC: 4435774. DOI: 10.1186/s12885-015-1331-9. View

18.

Sevick-Muraca E, Sharma R, Rasmussen J, Marshall M, Wendt J, Pham H . Imaging of lymph flow in breast cancer patients after microdose administration of a near-infrared fluorophore: feasibility study. Radiology. 2008; 246(3):734-41. PMC: 3166516. DOI: 10.1148/radiol.2463070962. View

19.

Derossis A, Fey J, Cody 3rd H, Borgen P . Obesity influences outcome of sentinel lymph node biopsy in early-stage breast cancer. J Am Coll Surg. 2003; 197(6):896-901. DOI: 10.1016/j.jamcollsurg.2003.08.005. View

20.

Patnaik J, Byers T, DiGuiseppi C, Dabelea D, Denberg T . Cardiovascular disease competes with breast cancer as the leading cause of death for older females diagnosed with breast cancer: a retrospective cohort study. Breast Cancer Res. 2011; 13(3):R64. PMC: 3218953. DOI: 10.1186/bcr2901. View