e12006 Background: Methylene blue (MB) dye is widely used in China for sentinel lymph node biopsy (SLNB). Recently indocyanine green (ICG) was reported to be an innovative fluorescent tracer that could be visualized by near-infrared camera. In this study we compared the efficacy of combined use of ICG fluorescence and methylene blue eye versus methylene blue alone for SLNB in breast cancer patients. Methods: Two hundred and sixteen consecutive early breast cancer patients in our hospital underwent SLNB from December 2010 to May 2012, 107 patients received combined use of ICG and MB as the lymphatic mapping tracer and 109 patients received MB alone. In combination group, sentinel lymph nodes were identified by ICG fluorescence using a near-infrared camera and/or blue dye, while in blue dye alone group sentinel lymph nodes were identified as blue nodes along the blue lymphatic vessel. Intra-operative frozen section analysis was performed, followed by conventional histopathologic examination. Results: In combination group, subcutaneous lymphatic channels were successfully visualized in all the patients, 325 sentinel lymph nodes were identified in 105 patients. While in blue dye alone group, 242 SLNs were found in 100 patients. The detection rate was 98.1% vs. 91.7 %(p=0.033), the average number of SLNs was 3.1 versus 2.4(p<0.001). 29 metastatic SLNs were found in 19 patients by combination method vs. 21 metastatic SLNs in 17 patients by MB alone. No axillary recurrence was observed in either group during 16 months of median follow-up. Conclusions: The combined use of ICG fluorescence and MB enables visualized and more sensitive SLN detection than MB alone.
Lymphoscintigraphy with peritumoral injectionversuslymphoscintigraphy with subdermal periareolar injection of technetium-labeled human albumin to identify sentinel lymph nodes in breast cancer patients