Biópsia do Gânglio Sentinela Guiada por Fluorescência no Cancro da Mama: Taxa de Deteção e Performance Diagnóstica

Introduction: Sentinel lymph node biopsy is currently the standard surgical procedure for lymph node staging in patients with early stage breast cancer. It is performed using different techniques, such as the injection of vital dyes and / or radioisotopes and, more recently, guided by fluorescence using Indocyanine green. The aim of this study is to assess the detection rate of sentinel lymph node using Indocyanine green in breast cancer patients according to factors related to the patient and the tumor.Material and Methods: Retrospective study of a random sample of patients with breast cancer, treated and followed at Centro Hospitalar São João, in Porto, between 2012 and 2016.Results: Indocyanine green detection rate was over 90% and its diagnostic accuracy was similar to other methods described in the presence of metastatic involvement of lymph nodes.Discussion: There was no statistically significant difference between the three methods in the detection rates in subgroups of older women, with normal weight and in those who underwent previous surgery in breast or axilla or neo-adjuvant chemotherapy.Conclusion: Indocyanine green is a potential alternative method to other sentinel lymph node screening techniques, appearing as a future option for breast cancer centers with no nuclear medicine department. However, it is essential to carry out further research in order to define the ideal patients’ profile that maximizes the method’s effectiveness.

Download Full-text

Standardized comparison of radioguided surgery with indocyanine green detection of the sentinel lymph node in early stage breast cancer patients: Personal experience and literature review

Journal of Cancer Research and Therapeutics ◽

10.4103/jcrt.jcrt_772_19 ◽

2021 ◽

Vol 0 (0) ◽

pp. 0

Author(s):

Marco Gipponi ◽

Piero Fregatti ◽

Marco Sparavigna ◽

Raquel Diaz ◽

Federica Murelli ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Literature Review ◽

Indocyanine Green ◽

Cancer Patients ◽

Personal Experience ◽

Early Stage ◽

Radioguided Surgery ◽

Breast Cancer Patients

Download Full-text

A Novel Finding of Sentinel Lymphatic Channels in Early Stage Breast Cancer Patients: Which May Influence Detection Rate and False-Negative Rate of Sentinel Lymph Node Biopsy

PLoS ONE ◽

10.1371/journal.pone.0051226 ◽

2012 ◽

Vol 7 (12) ◽

pp. e51226 ◽

Cited By ~ 11

Author(s):

Minghai Wang ◽

Wenbin Zhou ◽

Yingchun Zhao ◽

Tiansong Xia ◽

Xiaoming Zha ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Detection Rate ◽

Early Stage ◽

False Negative ◽

False Negative Rate ◽

Lymph Node Biopsy ◽

Breast Cancer Patients ◽

Node Biopsy

Download Full-text

Technetium-99m-indocyanine green versus technetium-99m-methylene blue for sentinel lymph node biopsy in early-stage endometrial cancer

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2019-000923 ◽

2020 ◽

Vol 30 (3) ◽

pp. 311-317 ◽

Cited By ~ 1

Author(s):

Silvia Cabrera ◽

Vicente Bebia ◽

Silvia Franco-Camps ◽

Cristina Forcada ◽

Diego Villasboas-Rosciolesi ◽

...

Keyword(s):

Methylene Blue ◽

Endometrial Cancer ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Indocyanine Green ◽

Detection Rate ◽

Early Stage ◽

Detection Rates ◽

Technetium 99M ◽

Early Stage Endometrial Cancer

IntroductionThe low accuracy of pre-operative imaging techniques for prediction of nodal status strengthens the relevance of sentinel lymph node (SLN) biopsy in endometrial cancer, although the optimal method for its detection is still under investigation. The increasing use of indocyanine green (ICG) has aroused concern about its enhanced visualization of lymphatic channels, which could lead to a specimen that is thought to be nodal tissue not subsequently yielding a lymph node on pathologic analysis ('empty node packet'). Our main objective was to compare the overall and bilateral detection rates for SLN biopsy using two combined techniques: technetium-99m-ICG (Tc-99m-ICG) versus technetium-99m-methylene blue (Tc-99m-MB). Our secondary aim was to compare the ‘empty node packet’ rates between the two cohorts.MethodsA prospective, non-randomized, single-center trial including patients diagnosed with endometrial cancer (any grade or histology) in pre-operative early stage, and operated on between February 2017 and July 2019. All tracers were injected intracervically. Pelvic and aortic lymphadenectomy were performed on patients at intermediate or high risk of recurrence pre-operatively. All SLNs were sent for intra-operative frozen section and afterwards processed following an ultrastaging protocol.ResultsEighty-four patients were included, 58% (n=49) in the Tc-99m-MB group and 42% (n=35) in the Tc-99m-ICG group. Overall detection rate was 93% and was not statistically different between the two groups. A better bilateral detection rate was observed among Tc-99m-ICG patients (69% vs 41%, p=0.012). The 'empty node packet' rate was 4% in the Tc-99m-ICG cohort and 0% in the Tc-99m-MB cohort (p=0.032).DiscussionTc-99m-ICG is a feasible, safe technique for SLN biopsy in early-stage endometrial cancer, and appears to be superior in terms of bilateral detection to Tc-99m-MB. The addition of Tc-99m to ICG could decrease the rate of 'empty node packets' and better define the anatomic location of SLNs in patients with endometrial cancer.

Download Full-text