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Research ArticleOriginal Article

Comparison of sentinel lymph node detection performances using blue dye in conjunction with indocyanine green or radioisotope in breast cancer patients: a prospective single-center randomized study

Long Yuan, Xiaowei Qi, Yi Zhang, Xinhua Yang, Fan Zhang, Linjun Fan, Li Chen, Kongyong Zhang, Ling Zhong, Yanling Li, Sijie Gan, Wenying Fu and Jun Jiang
Cancer Biology & Medicine November 2018, 15 (4) 452-460; DOI: https://doi.org/10.20892/j.issn.2095-3941.2018.0270
Long Yuan
1Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
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Xiaowei Qi
1Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
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Yi Zhang
1Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
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Xinhua Yang
1Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
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Fan Zhang
1Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
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Linjun Fan
1Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
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Li Chen
1Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
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Kongyong Zhang
1Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
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Ling Zhong
1Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
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Yanling Li
1Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
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Sijie Gan
1Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
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Wenying Fu
1Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
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Jun Jiang
1Department of Breast Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
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  • For correspondence: jcbd{at}medmail.com.cn
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    1

    Indocyanine green revealed clear lymphatic pathway and lymph nodes under the fluorescent detector. (A) Injection site for indocyanine green. (B) A segment of fluorescent-positive lymphatic vessel. (C) An indocyanine green-positive sentinel lymph node.

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    1

    Patient demographics and tumor characteristics

    Characteristics99Tcm-Dx+BD (n=271) ICG+BD (n=200) P
    n Percentage (%)n Percentage (%)
    Mean age at diagnosis, years0.09
     ≤ 5016560.8913768.50
     >5010639.116331.50
    Menopausal status0.11
     Pre-menopausal16059.0413366.50
     Post-menopausal11140.966733.50
    BMI0.27
     <18.562.2142.00
     18.5–24.918267.1614874.00
     ≥258330.634824.00
    Tumor side0.62
     Left13650.1810552.50
     Right13549.829547.50
    Quadrant0.37
     Upper outer16460.5211155.50
     Lower outer3211.812412.00
     Upper inner5520.304020.00
     Lower inner124.43126.00
     Nipple-areolar area82.95136.50
    Adjuvant chemotherapy0.08
     Yes238.492713.50
     No24891.5117386.50
    Surgical procedure0.51
     SLN20977.1214974.50
     SLN+ALND6222.885125.50
    Histological type0.67
     Invasive ductal21679.7016683.00
     Invasive lobular51.8521.00
      In situ 3412.552412.00
     Other165.9084.00
    pT stage0.43
     Tis3211.81199.50
     T19535.068442.00
     T214152.039447.00
     T331.1131.50
    pN stage0.22
     N020475.2814673.00
     N15620.664422.00
     N293.3242.00
     N320.7463.00
    pTNM0.43
     03111.44189.00
     I7628.046733.50
     II15256.0910351.50
     III124.43126.00
    ER0.60
     Positive21077.4915979.50
     Negative6122.514120.50
    PR0.32
     Positive20274.5415778.50
     Negative6925.464321.50
    HER20.60
     Positive5721.034623.00
     Negative21478.9715477.00
    Ki-670.70
     <14%12746.869045.00
     >14%14456.6911055.00

    ICG: indocyanine green; BD: blue dye; BMI: body mass index; p: pathological; SLN: sentinel lymph node biopsy; ALND: axillary lymph node dissection; ER: estrogen receptors; PR: progesterone receptors; HER2: human epidermal growth factor receptor 2

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      2

      Efficacy of indocyanine green vs. radioisotope + blue dye for sentinel lymph node mapping in breast cancer patients

      Parameters99Tcm-Dx+BD (n = 271) ICG+BD (n = 200) P
      ICG: indocyanine green; BD: blue dye.
      SLN identification rate (%)99.6 (270/271)99.0 (198/200)0.790
      SLN counts3.91±2.133.72±2.280.090
      Metastatic SLN rate (%)22.9 (62/271)25.5 (51/200)0.510
      Metastatic SLN counts0.34±0.780.38±0.840.460
      Sensitivity92.5 (62/67)94.4 (51/54)0.960
      False-negative rate (%)7.5 (5/67)5.6 (3/54)
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    Cancer Biology and Medicine: 15 (4)
    Cancer Biology & Medicine
    Vol. 15, Issue 4
    1 Nov 2018
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    Comparison of sentinel lymph node detection performances using blue dye in conjunction with indocyanine green or radioisotope in breast cancer patients: a prospective single-center randomized study
    Long Yuan, Xiaowei Qi, Yi Zhang, Xinhua Yang, Fan Zhang, Linjun Fan, Li Chen, Kongyong Zhang, Ling Zhong, Yanling Li, Sijie Gan, Wenying Fu, Jun Jiang
    Cancer Biology & Medicine Nov 2018, 15 (4) 452-460; DOI: 10.20892/j.issn.2095-3941.2018.0270

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    Comparison of sentinel lymph node detection performances using blue dye in conjunction with indocyanine green or radioisotope in breast cancer patients: a prospective single-center randomized study
    Long Yuan, Xiaowei Qi, Yi Zhang, Xinhua Yang, Fan Zhang, Linjun Fan, Li Chen, Kongyong Zhang, Ling Zhong, Yanling Li, Sijie Gan, Wenying Fu, Jun Jiang
    Cancer Biology & Medicine Nov 2018, 15 (4) 452-460; DOI: 10.20892/j.issn.2095-3941.2018.0270
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    Keywords

    • breast cancer
    • indocyanine green
    • sentinel lymph node
    • biopsy
    • lymphography

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