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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2016

01-01-2016 | Breast Oncology

Evaluation of the Clinical Utility of the ICG Fluorescence Method Compared with the Radioisotope Method for Sentinel Lymph Node Biopsy in Breast Cancer

Authors: Tomoharu Sugie, MD, PhD, Takayuki Kinoshita, MD, PhD, Norikazu Masuda, MD, PhD, Terumasa Sawada, MD, PhD, Akira Yamauchi, MD, PhD, Katsumasa Kuroi, MD, PhD, Tetsuya Taguchi, MD, PhD, Hiroko Bando, MD, PhD, Hiroyasu Yamashiro, MD, PhD, Tecchuu Lee, MD, PhD, Nobuhiko Shinkura, MD, PhD, Hironori Kato, MD, PhD, Takafumi Ikeda, PhD, Kenichi Yoshimura, PhD, Hanae Ueyama, PhD, Masakazu Toi, MD, PhD

Published in: Annals of Surgical Oncology | Issue 1/2016

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Abstract

Purpose

This study compared the clinical utility of indocyanine green (ICG) fluorescence and radioisotope (RI) for sentinel lymph node (SLN) detection in breast cancer.

Methods

Women with node-negative breast cancer underwent SLN biopsy using ICG fluorescence and RI. The primary end point was the sensitivity of ICG fluorescence compared with RI in the patients with tumor-positive SLNs. Secondary end points included detection rates for SLN, the additive effect of ICG fluorescence to RI, signature of positive SLNs according to tier, and adverse events related to ICG administration.

Results

A total of 847 women with clinical node-negative breast cancer underwent SLN biopsy, and 821 patients were included in the per-protocol analysis. SLN mapping was performed using ICG fluorescence and RI. The overall detection of SLNs using ICG fluorescence was identical to RI (97.2 vs. 97.0 %, P = 0.88), and the combination of both methods achieved a significant improvement compared with RI alone (99.8 vs. 97.0 %, P < 0.001). The detection rate for tumor-positive SLN was 93.3 % for ICG fluorescence and 90.0 % for RI, and the sensitivity of the ICG fluorescence method was 95.7 % (95 % CI 91.3–98.3, P = 0.11). The additional use of ICG significantly improved positive SLN detection for RI (97.2 vs. 90.0 %, P < 0.001). There were no serious adverse events related to hypersensitivity to ICG.

Conclusions

The ICG fluorescence method may be an acceptable alternative to SLN detection using RI in breast cancer.
Literature
1.
Cody HS 3rd, Fey J, Akhurst T, Fazzari, M., Mazumdar, M., Yeung, H, et al. Complemental of blue dye and isotope in sentinel node localization for breast cancer: univariate and multivariate analysis of 966 procedures. Ann Surg Oncol. 2001;18:2560–6.
2.
Tafra L, Lannin DR, Swanson MS, Van Eyk, J. J., Verbanac, K. M., Chua, A. N., et al. Multicenter trial of sentinel node biopsy for breast cancer using both technetium sulfur colloid and isosulfan blue dye. Ann Surg. 2001;233:51–9.PubMedPubMedCentralCrossRef
3.
Krag DN, Anderson SJ, Julian TB, Brown, A. M., Harlow, S. P., Ashikaga, T., et al. Technical outcome of sentinel-lymph-node resection and conventional axillary lymph node dissection in patients with clinically node-negative breast cancer: result from the NSABP B-32 randomised phase III trial. Lancet Oncol. 2007;8:881–8.PubMedCrossRef
4.
Morrow M, Rademaker AW, Bethke KP, Talamonti, M. S., Dawes, L. G., Clauson, J, et al. Learning sentinel node biopsy: results of a prospective randomized trial of two techniques. Surgery. 1999;126:714–20.PubMedCrossRef
5.
Kitai T, Inomoto T, Miwa M, Shikayama T. Fluorescence navigation with indocyanine green for detecting sentinel lymph nodes in breast cancer. Breast Cancer. 2005;12:211–5.PubMedCrossRef
6.
Sugie T, Kassim KA, Takeuchi M, Hashimoto, T., Yamagami, K., Masai, Y, et al. A novel method for sentinel lymph node biopsy by indocyanine green fluorescence technique in breast cancer. Cancers. 2010;2:713–20.PubMedPubMedCentralCrossRef
7.
Takeuchi M, Sugie T, Abdelazeem K, Kato, H., Shinkura, N., Takada, M, et al. Lymphatic mapping with fluorescence navigation using indocyanine green and axillary surgery in patients with primary breast cancer. Breast J. 2012;18:535–41.PubMedCrossRef
8.
Abe H, Mori T, Umeda T, Tanaka, M., Kawai, Y., Shimizu, T., et al. Indocyanine green fluorescence imaging system for sentinel lymph node biopsies in early breast cancer patients. Surg Today. 2011;41:197–202.PubMedCrossRef
9.
Tagaya N, Yamazaki R, Nakagawa A, Abe, A., Hamada, K., Kubota, K., et al. Intraoperative identification of sentinel lymph node by near-infrared fluorescence imaging in patients with breast cancer. Am J Surg. 2008;195:850–3.PubMedCrossRef
10.
Tagaya N, Aoyagi H, Nakagawa A, Abe, A., Iwasaki, Y., Tachibana, M., et al. A novel approach for sentinel lymph node identification using fluorescence imaging and image overlay navigation surgery in patients with breast cancer. World J Surg. 2011;35:154–8.PubMedCrossRef
11.
Sugie T, Sawada T, Tagaya N, Kinoshita, T., Yamagami, K., Suwa, H., et al. Comparison of the indocyanine green fluorescence and blue dye methods in detection of sentinel lymph nodes in early-stage breast cancer. Ann Surg Oncol. 2013;20:2213–8.PubMedCrossRef
12.
Inoue T, Nishi T, Nakano Y, Nishimae, A., Sawai, Y., Yamasaki, M., et al. Axillary lymph node recurrence after sentinel lymph node biopsy performed using a combination of indocyanine green fluorescence and the blue dye method in early breast cancer. Breast Cancer. 2014. doi:10.​1007/​s12282-014-0573-8.
13.
Hojo T, Nagao T, Kikuyama M, Akashi S, Kinoshita T. Evaluation of sentinel node biopsy by combined fluorescence and dye method and lymph flow for breast cancer. Breast. 2010;19:210–3.PubMedCrossRef
14.
Wishart GC, Loh SW, Jones L, Benson JR. A feasibility study (ICG-10) of indocyanine green (ICG) fluorescence mapping for sentinel lymph node detection in early breast cancer. Eur J Surg Oncol. 2012;38:651–6.PubMedCrossRef
15.
van der Vorst JR, Schaafsma BE, Verbeek FP, Hutteman, M., Mieog, J. S. D., Lowik, C. W., et al. Randomized comparison of near-infrared fluorescence imaging using indocyanine green and 99mtechnetium with or without patent blue for the sentinel lymph node procedure in breast cancer patients. Ann Surg Oncol. 2012;19:4104–11.PubMedPubMedCentralCrossRef
16.
Ballardini B, Santoro L, Sangalli C, Gentilini, O., Renne, G., Lissidini, G., et al. The indocyanine green method is equivalent to the 99mTc-labeled radiotracer method for identifying the sentinel node in breast cancer: a concordance and validation study. Eur J Surg Oncol. 2013;39:1332–6.PubMedCrossRef
17.
Schaafsma BE, Verbeek FP, Riebergen DD, Hiel, B., Vorst, J. R., Liefers, G. J., et al. Clinical trial of combined radio- and fluorescence-guided sentinel lymph node biopsy in breast cancer. Br J Surg. 2013;100:1037–44.PubMedPubMedCentralCrossRef
18.
Tamaki Y, Akiyama F, Iwase T, Kaneko, T., Tsuda, H., Sato, K., et al. Molecular detection of lymph node metastases in breast cancer patients: results of a multicenter trial using the one-step nucleic acid amplification assay. Clin Cancer Res. 2009;15:2879–84.PubMedCrossRef
19.
Murawa D, Hirche C, Dresel S, Hünerbein M. Sentinel lymph node biopsy in breast cancer guided by indocyanine green fluorescence. Br J Surg. 2009;96:1289–94.PubMedCrossRef
20.
Verbeek FP, Troyan SL, Mieog JS, Liefers, G. J., Moffitt, L. A., Rosenberg, M., et al. Near-infrared fluorescence sentinel lymph node mapping in breast cancer: a multicenter experience. Breast Cancer Res Treat. 2014;143:333–42.PubMedPubMedCentralCrossRef
21.
Samorani D, Fogacci T, Panzini I, Frisoni, G., Accardi, F. G., Ricci, M., et al. The use of indocyanine green to detect sentinel nodes in breast cancer: a prospective study. Eur J Surg Oncol. 2015;41:64–70.PubMedCrossRef
22.
Reuthebuch O, Haussler A, Genoni M, Tavakoli, R., Odavic, D., Kadner, A., et al. Novadaq SPY: intraoperative quality assessment in off-pump coronary artery bypass grafting. Chest. 2004;125:418–24.PubMedCrossRef
23.
Troyan SL, Kianzad V, Gibbs-Strauss SL, Gioux, S., Matsui, A., Oketokoun, R., et al. The FLARE intraoperative near-infrared fluorescence imaging system: a first-in-human clinical trial in breast cancer sentinel lymph node mapping. Ann Surg Oncol. 2009;16:2943–52.PubMedPubMedCentralCrossRef
24.
Ahmed M, Purushotham AD, Douek M. Novel techniques for sentinel lymph node biopsy in breast cancer: a systematic review. Lancet Oncol. 2014;15:e351–62.PubMedCrossRef
25.
Lyman GH, Temin S, Edge SB, Newman, L. A., Turner, R. R., Weaver, D. L., et al. Sentinel lymph node biopsy for patients with early-stage breast cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2014;32:1365–83.PubMedCrossRef
Metadata
Title
Evaluation of the Clinical Utility of the ICG Fluorescence Method Compared with the Radioisotope Method for Sentinel Lymph Node Biopsy in Breast Cancer
Authors
Tomoharu Sugie, MD, PhD
Takayuki Kinoshita, MD, PhD
Norikazu Masuda, MD, PhD
Terumasa Sawada, MD, PhD
Akira Yamauchi, MD, PhD
Katsumasa Kuroi, MD, PhD
Tetsuya Taguchi, MD, PhD
Hiroko Bando, MD, PhD
Hiroyasu Yamashiro, MD, PhD
Tecchuu Lee, MD, PhD
Nobuhiko Shinkura, MD, PhD
Hironori Kato, MD, PhD
Takafumi Ikeda, PhD
Kenichi Yoshimura, PhD
Hanae Ueyama, PhD
Masakazu Toi, MD, PhD
Publication date
01-01-2016
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 1/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4809-4

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