Evaluation of the role of indocyanine green in mapping of axillary sentinel lymph node biopsy

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Abstract

Background
Axillary lymph nodes (LNs) are known to be the most important prognostic factor for recurrence and survival in the management of patients with early breast cancer. Blue dye and radioactive isotopes are the most widely used tracers in the mapping of axillary sentinel node (SN) biopsy. These tracers still have several drawbacks. Indocyanine green (ICG) has the potential for guiding SN biopsy.
Patients and methods
A total of 35 patients with early breast cancer, clinically and radiologically node negative, underwent SN biopsy with combined ICG and patent blue (PB) dye for localization of SNs. The obtained lymph nodes were histopathologically investigated.
Outcomes
This study aimed to assess the feasibility of using ICG for SN biopsy, to calculate the detection rate, and to assess the safety of ICG dye.
Results
The mean age of the patients was 51.94 years. The detection rate of SN depending on ICG was 100 and 91% depending on the PB dye visualization. Of 129 SNs dissected from the 35 recruited patients, a mean of 2.31 ± 1.23 nodes/patient were seen in case of SN detection by the PB dye and a mean of 3.69 ± 0.72 nodes/patient in case of SN detection by ICG (<0.001). No complications or adverse actions were recorded in all patients.
Conclusion
This study demonstrated that ICG is a feasible technique for SN biopsy with a high detection rate and can be used safely.

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