Abstract
This study aimed to assess the efficacy of the combination of indocyanine green (ICG) and methylene blue (MB) dye in early breast cancer patients undergoing sentinel lymph node biopsy (SLNB). Between January 2011 and December 2015, 1061 early breast cancer patients underwent SLNB were included. SLNB was performed for enrolled patients by injection of both ICG and MB. Detection rate, positivity, and number of sentinel lymph nodes (SLNs) by ICG and MB were analysed. Axillary recurrence and arm lymphedema at 5.6-year follow-up were reported. The combination of ICG and MB resulted in a very high detection rate of 99.6%, the median number of sentinel lymph nodes was 3. A total of 374 histologically confirmed positive SLNs were detected in 237 patients, 96.6% of the positive patients and 94.1% of the positive nodes could be identified by the combination of ICG and MB. After a median follow-up of 5.6 (2-9.3) years, 0.64% of patients with negative SLNs had ipsilateral axillary recurrence, and the incidence of arm lymphedema was 2.1%. Although the missing isotope control weakens the interpretation of the findings, the dual tracing modality of ICG and MB, without involvement of radioactive isotopes, was an effective method for SLNB in patients with early breast cancer. ACTRN12612000109808. Registered on 23 January 2012.
Highlights
Sentinel lymph node biopsy (SLNB) was first applied in breast cancer care in the 1990s by Krag et al [1], and has become the standard procedure for patients with clinically negative axilla [2]
A total of 374 histologically confirmed positive sentinel lymph nodes (SLNs) were detected in 237 patients, 96.6% of the positive patients and 94.1% of the positive nodes could be identified by the combination of indocyanine green (ICG) and methylene blue (MB)
Conclusions the missing isotope control weakens the interpretation of the findings, the dual tracing modality of ICG and MB, without involvement of radioactive isotopes, was an effective method for SLNB in patients with early breast cancer
Summary
Sentinel lymph node biopsy (SLNB) was first applied in breast cancer care in the 1990s by Krag et al [1], and has become the standard procedure for patients with clinically negative axilla [2]. A dual tracer of blue dye and radioisotope (RI) can improve detection of SLNs and reduce the false negative rate (FNR) [8] and has been recommended as the standard technique in guidelines [9]. It was reported that the standard dual technique of RI and blue dye was significantly better than microbubbles in terms of SLNs identification rate [9]. ICG was one of the most promising technique because of the high SLNs identification rate (93%-100%) and was the most commonly used non-radioactive tracer in clinical trials of SLNB [12]. We reported that dual tracer of MB and ICG improved the mapping performance in 198 patients with early breast cancer [16]. We report the final results for 1061 patients from this prospective cohort study, for SLN detection, and for long-term axillary recurrence
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
