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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 8/2019

01-08-2019 | Breast Cancer | Breast Oncology

The Sentinel Lymph Node Biopsy Using Indocyanine Green Fluorescence Plus Radioisotope Method Compared With the Radioisotope-Only Method for Breast Cancer Patients After Neoadjuvant Chemotherapy: A Prospective, Randomized, Open-Label, Single-Center Phase 2 Trial

Authors: So-Youn Jung, MD, PhD, Jai Hong Han, MD, Soo Jin Park, MD, Eun-Gyeong Lee, MD, Joohwa Kwak, MD, Sun Hye Kim, MD, Moo Hyun Lee, MD, PhD, Eun Sook Lee, MD, PhD, Han-Sung Kang, MD, PhD, Keun Seok Lee, MD, PhD, In Hae Park, MD, PhD, Sung Hoon Sim, MD, PhD, Hae Jeong Jeong, MD, PhD, Youngmee Kwon, MD, PhD, Dong-Eun Lee, MS, Seok-Ki Kim, MD, PhD, Seeyoun Lee, MD, PhD

Published in: Annals of Surgical Oncology | Issue 8/2019

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Abstract

Background

This study aimed to compare the sentinel lymph node (SLN) identification rates for breast cancer patients after neoadjuvant chemotherapy (NAC) between the dual method (DM) of indocyanine green fluorescence (ICG-F) plus a radioisotope (RI) and RI alone.

Methods

This randomized study enrolled 130 patients who received NAC for breast cancer and 122 patients who received SLN biopsy (SLNB) using either DM (n = 58) or RI only (n = 64). The study compared the identification rate, number of SLNs, and detection time of SLNB.

Results

Among the 122 patients, 113 (92.6%) were clinically node-positive before NAC. The SLN identification rate was 98.3% in the DM group and 93.8% in the RI group (p = 0.14). The DM group and the RI group were similar in the average number of SLNs (2.2 ± 1.13 vs. 1.9 ± 1.33; p = 0.26) and the time to detection of the first SLN (8.7 ± 4.98 vs. 8.3 ± 4.31 min; p = 0.30). In the DM group, transcutaneous lymphatic drainage was visualized by fluorescence imaging for 65.5% (38 of 58) of the patients. The SLN identification rate was 94.7% using ICG-F and 93% using RI (p = 0.79). During and after the operation, no complications, including allergic reactions or skin necrosis, occurred.

Conclusions

This study is the first randomized trial to use ICG-F for SLNB in breast cancer patients after NAC. The DM including ICG-F could be a feasible and safe method for SLNB in initially node-positive breast cancer patients with NAC.
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Metadata
Title
The Sentinel Lymph Node Biopsy Using Indocyanine Green Fluorescence Plus Radioisotope Method Compared With the Radioisotope-Only Method for Breast Cancer Patients After Neoadjuvant Chemotherapy: A Prospective, Randomized, Open-Label, Single-Center Phase 2 Trial
Authors
So-Youn Jung, MD, PhD
Jai Hong Han, MD
Soo Jin Park, MD
Eun-Gyeong Lee, MD
Joohwa Kwak, MD
Sun Hye Kim, MD
Moo Hyun Lee, MD, PhD
Eun Sook Lee, MD, PhD
Han-Sung Kang, MD, PhD
Keun Seok Lee, MD, PhD
In Hae Park, MD, PhD
Sung Hoon Sim, MD, PhD
Hae Jeong Jeong, MD, PhD
Youngmee Kwon, MD, PhD
Dong-Eun Lee, MS
Seok-Ki Kim, MD, PhD
Seeyoun Lee, MD, PhD
Publication date
01-08-2019
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 8/2019
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-019-07400-0

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