Abstract P5-01-09: Evaluation of the efficacy of using fluorescence-associated indocyanine green in sentinel lymph node biopsies from breast cancer patients

Abstract

Abstract Introduction: Sentinel lymph node biopsy is the technique of choice for axillary staging in patients with breast cancer. Although it is already a widespread technique, its history is relatively recent. Three techniques are globally used to detect sentinel lymph nodes: the patent blue, described by Giuliano et al. (1994); the technetium-99 radiopharmaceutical with gamma probe, published by Krag et al. (1993); and the combination of these two techniques. Objective: This study aims to evaluate sentinel lymph node detection rate using the innovative fluorescence-associated indocyanine green technique in breast cancer patients, and to compare it with that of patent blue and with a combination of the two dyes. Method: A randomized trial was conducted on 99 patients who were equally divided into three arms, each one undergoing sentinel lymph node detection using either patent blue, indocyanine green, or a combination of the two dyes. The study was conducted at Hospital de Esperança, Presidente Prudente, SP, Brazil, in partnership with the Breast Department of Paulista School of Medicine, Federal University of São Paulo. Results: The accuracy rate in identifying sentinel lymph nodes was 78.8% with patent blue, 93.9% with indocyanine green, and 100% with patent blue + indocyanine green. Two sentinel nodes (48.5%) were mostly identified in the combined group; however, only one sentinel node was identified in the other groups. The mean time for sentinel lymph node identification was 20.6 minutes with the traditional dye, 8.6 minutes with indocyanine green, and 10 minutes with the combination of the two methods (p < 0.001). The mean surgical time was 69.4 minutes with patent blue, 55.1 minutes with indocyanine green, and 69.4 minutes with their combination (p < 0.001). Conclusion: Sentinel lymph node detection rate by fluorescence-associated indocyanine green was considered effective. The comparison of sentinel lymph node detection rates between patent blue, indocyanine green, and a combination of patent blue + indocyanine green revealed statistically significant differences (p = 0.030), with the combined method being the most effective. Keywords: breast neoplasm, sentinel lymph node biopsy, fluorescence, indocyanine green Citation Format: Rafael Sá, Afonso Nazário, Vanessa M. Sanvido, Roberto Giordano, Raquel Rodrigues, Luiz Bugalho, Suelen Silva. Evaluation of the efficacy of using fluorescence-associated indocyanine green in sentinel lymph node biopsies from breast cancer patients [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-01-09.