Targeted Axillary Lymph Node Dissection after Neoadjuvant Treatment of Breast Cancer Using Indocyanine Green Compared to Patent Blue V Dye

Document Type : Original Article

Authors

Department of General Surgery, Faculty of Medicine, Ain Shams University, Egypt.

10.21608/ejsur.2024.344921.1317

Abstract

Background: For patients with breast cancer, targeted axillary lymph node dissection (TAD) after neoadjuvant therapy
is an essential surgery for precise axillary staging. TAD with sentinel lymph node (SLN) detection may be enhanced by
using indocyanine green (ICG), a promising substitute for conventional dyes. The effectiveness of ICG and patent blue
V dye (PBVD) in identifying targeted axillary LNs and SLNs during axillary dissection in patients with breast cancer
following neoadjuvant treatment is being compared in this prospective randomized controlled experiment. As a result,
there will be less need for a full axillary LN dissection and fewer side effects.
Patients and Methods: This study was conducted at Ain Shams University Hospitals between October 2022 and March
2024. A total of 60 breast cancer patients received neoadjuvant therapy and were prepared for surgery of TAD. They were
randomized in a 1:1 ratio using randomization software (random.org) into two groups: group A underwent TAD using ICG
dye and group B underwent TAD using PBVD. The primary endpoint was the targeted LN, as well as the SLNs removed
detection rate, number, and accuracy.
Results: The study examined variations in the two groups’ SLN detection rates, the quantity of SLNs found, and their
adverse consequences. In comparison to PBVD, ICG is said to have shown better SLN detection and identification, as
well as fewer problems and adverse effects.
Conclusion: The purpose of this experiment is to determine if ICG provides a more accurate and dependable technique
for both targeted LN and SLN detection in patients with breast cancer who have received neoadjuvant treatment. By
increasing nodal staging accuracy and lowering the possibility of missing sentinel nodes, the data could validate ICG as
the preferred tracer for TAD.

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