Comparison of the Indocyanine Green Fluorescence and Blue Dye Methods in Detection of Sentinel Lymph Nodes in Early-stage Breast Cancer

• Published in: Annals of surgical oncology 2013-07, Vol.20 (7), p.2213-2218
• Main Authors: Sugie, Tomoharu, Sawada, Terumasa, Tagaya, Nobumi, Kinoshita, Takayuki, Yamagami, Kazuhiko, Suwa, Hirofumi, Ikeda, Takafumi, Yoshimura, Kenichi, Niimi, Miyuki, Shimizu, Akira, Toi, Masakazu
• Format: Article
• Language: English
• Subjects: Adult; Aged; Axilla; Breast Neoplasms - pathology; Breast Oncology; Carcinoma in Situ - pathology; Carcinoma, Ductal, Breast - secondary; Carcinoma, Ductal, Breast - surgery; Coloring Agents; Female; Fluorescence; Humans; Indigo Carmine; Indocyanine Green; Lymph Nodes - pathology; Lymphatic Metastasis; Medicine; Medicine & Public Health; Middle Aged; Oncology; Sentinel Lymph Node Biopsy - methods; Surgery; Surgical Oncology
• ISSN: 1068-9265; 1534-4681
• DOI: 10.1245/s10434-013-2890-0

Purpose To assess the diagnostic performance of sentinel lymph node (SLN) biopsy using the indocyanine green (ICG) fluorescence method compared with that using the blue dye method, a prospective multicenter study was performed. Methods Patients with T1–3 primary breast cancer without clinical lymph node involvement were included in this study. ICG as a fluorescence-emitting source and indigo carmine as blue dye were injected into the subareolar area. Extracted lymph nodes were examined to identify the first, second, and other SLNs. The identified nodes were classified according to the ICG fluorescence signal and blue dye uptake. Results Ninety-nine eligible patients were included in this study. The ICG fluorescence method identified an average of 3.4 SLNs (range, 1–8) in 98 of 99 patients (detection rate, 99 %). The number of lymph nodes identified by the fluorescence method was significantly higher than that identified by the blue dye method ( p