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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 13/2012

01-12-2012 | Breast Oncology

A Comparison of Indocyanine Green Fluorescence Imaging Plus Blue Dye and Blue Dye Alone for Sentinel Node Navigation Surgery in Breast Cancer Patients

Authors: Akira Hirano, MD, PhD, Mari Kamimura, MD, Kaoru Ogura, MD, Naomi Kim, MD, Akinori Hattori, MD, Yumika Setoguchi, MD, Fumie Okubo, MD, Hiroaki Inoue, MD, Reiko Miyamoto, MD, Jun Kinoshita, MD, PhD, Mariko Fujibayashi, MD, PhD, Tadao Shimizu, MD, PhD

Published in: Annals of Surgical Oncology | Issue 13/2012

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Abstract

Purpose

To evaluate two methods of sentinel node navigation surgery (SNNS) using blue dye with and without indocyanine green (ICG) fluorescence imaging (FI) to determine the usefulness of combined ICG and blue dye.

Methods

Between 2005 and 2010, a total of 501 patients underwent SNNS in our hospital. Detection of sentinel lymph node (SLN) was performed with sulfan blue (SB) alone until 2008 and with a combination of SB and ICG-FI since 2009. ICG 5 mg and SB 15 mg were injected in the subareolar region, and FI was obtained by a fluorescence imaging device.

Results

We attempted to identify SLNs in 393 patients by SB alone and in 108 patients by a combination of SB and FI. The mean number of SLNs detected was 1.6 (0–5) for SB alone and 2.2 (1–6) for the combination method. The SLN identification rate was 95.7 % for SB alone and 100 % for the combination method so that the combination was significantly superior to SB in terms of the identification rate (p = 0.0037). In patients who received the combination method, detection of SLN was made through only SB in 1 patient, only ICG in 8 patients, and both in 99 patients. Lymph node metastasis was found in 56 patients with SB alone and in 16 patients with the combination method. Recurrence of an axillary node was observed in 3 patients (0.8 %) with SB alone and in no patients with the combination method.

Conclusions

ICG-FI is a useful method and is especially recommended in cases where no radiotracers are available.
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Metadata
Title
A Comparison of Indocyanine Green Fluorescence Imaging Plus Blue Dye and Blue Dye Alone for Sentinel Node Navigation Surgery in Breast Cancer Patients
Authors
Akira Hirano, MD, PhD
Mari Kamimura, MD
Kaoru Ogura, MD
Naomi Kim, MD
Akinori Hattori, MD
Yumika Setoguchi, MD
Fumie Okubo, MD
Hiroaki Inoue, MD
Reiko Miyamoto, MD
Jun Kinoshita, MD, PhD
Mariko Fujibayashi, MD, PhD
Tadao Shimizu, MD, PhD
Publication date
01-12-2012
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 13/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-012-2478-0

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