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conferenceseries.com
Volume 2, Issue 3 (Suppl) Breast Can Curr Res, an open access journal
ISSN: 2572-4118 Breast Cancer 2017
June 15-17, 2017
June 15-17, 2017 London, UK
5th World Congress on
Breast Cancer
Real-time indocyanine green (ICG) fluorescence imaging technique for the detection of SLNs in
early-stage breast cancer
Uhi Toh and Yoshito Akagi
Kurume University, Japan
Background: The sentinel lymph nodes status of breast cancer is used to predict the status of the remaining axillary lymph
nodes accurately and sentinel lymph node biopsy (SLNB) provide staging information and to determine the need for axillary
lymph node dissection in breast cancer patients. The purpose of this study was to evaluate the utility of a color charge-coupled
device (CCD) camera system for the intraoperative detection of SLNs and to determine its clinical efficacy and sensitivity in
patients with operable breast cancer.
Methods:The intraoperative detection of SLNs was performed using the conventional IndigoCarmine dye (indigotindisulfonate
sodium) technique combined with a new Indocyanine green (ICG) imaging system (HyperEye Medical System: HEMS,
MIZUHO IKAKOGYO, Japan) to map SLNs, in which the lymphatic vessels and SLNs were visualized transcutaneously with
illuminating ICG fluorescence. One intradermal injection of 3.5ml indigo carmine (blue dye) mixed with 0.5ml indocyanine
green (ICG) was performed via the subareolar plexus followed by 5 minutes breast massage for dilating breast lymphatics.
After an inferior axillary incision, the search of SLN was guided by HEMs for lighting stained lymphatic channels leading to
blue-stained LNs.
Results: Between January 2012 and May 2013, SLNs were successfully identified in all 168 patients (detection rate: 100%).
By histopathology, the sensitivity was 93.8% for the detection of the metastatic involvement of SLNs (15 of 16 nodal-positive
patients). Immunohistology revealed one false-negative case among 16 patients (6.3%). After a median follow-up of 30.5
months, none of the patients presented with axillary recurrence.
Conclusion: These results suggest that the HEMS imaging system is a feasible and effective method for the detection of SLNs
in breast cancer. Furthermore, the HEMS device permitted the transcutaneous visualization of lymphatic vessels under light
conditions, thus facilitating the identification and detection of SLNs without affecting the surgical procedure, together with a
high sensitivity and specificity.
Biography
Uhi Toh has completed his MD and PhD from Kurume University School of Medicine. He is currently working as the Associate Professor of Department of Surgery
and the Director of Breast Surgery of Kurume University Hospital. He has published more than 50 papers in reputed journals.
Uhi Toh et al., Breast Can Curr Res 2017, 2:3(Suppl)
DOI: 10.4172/2572-4118-C1-005