Fluorescence lymphography for sentinal lymph node biopsy in breast cancer

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OBJECTIVE

To study diagnostic value of fluorescence lymphography for sentinel lymph node biopsy in breast cancer.

MATERIAL AND METHODS

The study enrolled 25 patients with breast cancer T1-2N0-1M0 between March 2023 and July 2023. Eight ones underwent neoadjuvant chemotherapy. In 3 patients, morphologically verified metastases cN1 in axillary lymph nodes regressed after treatment. After sentinel lymph node biopsy, all patients underwent standard axillary lymphadenectomy. Subareolar injection of indocyanine green 1 ml (5 mg/ml) was performed immediately before surgery. Fluorescence imaging was performed using the MARS system.

RESULTS

Detection rate was 100%. Mean number of sentinel lymph nodes was 2. Metastatic lesions of sentinel lymph nodes were observed in 6 patients (24%) with micro-metastases in 2 cases. In 50% of cases, metastatic lesion did not extend beyond sentinel lymph nodes. False negative result was obtained in 1 (4%) patient. Mean number of metastases was 1.8 (max 3 in one patient).

CONCLUSION

Sentinel lymph node biopsy with fluorescence lymphography is a sensitive method. The advantages of this technique are visualization of subcutaneous lymphatic vessels and skin incision for access to sentinel lymph nodes, as well as visualization of sentinel lymph nodes after skin incision.

Keywords:

breast cancer

sentinel lymph node biopsy

indocyanine green

fluorescence lymphography

Authors:

Bozhok A.A.

Saint Petersburg State Pediatric Medical University

ORCID: 0000-0002-1187-7989

Kashchenko V.A.

Sokolov North-Western Regional Scientific Clinical Center

ORCID: 0000-0002-4958-5850

Ratnikov V.A.

Sokolov North-Western Regional Scientific Clinical Center

ORCID: 0000-0002-9645-8408

Gornov S.V.

Russian Biotechnological University

ORCID: 0000-0002-3389-4309

Suvorova Yu.V.

Sokolov North-Western Regional Scientific Clinical Center

ORCID: 0000-0003-0183-8166

Manelov A.E.

Mechnikov North-Western State Medical University

ORCID: 0009-0009-7892-4768

Received:

15.10.2023

Accepted:

02.11.2023

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