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Clinical significance of discordances in sentinel lymph node reactivity between radioisotope and indocyanine green fluorescence in patients with cN0 breast cancer.
- Source :
-
Asian journal of surgery [Asian J Surg] 2023 Jan; Vol. 46 (1), pp. 277-282. Date of Electronic Publication: 2022 Apr 09. - Publication Year :
- 2023
-
Abstract
- Background: /Objective: To evaluate the usefulness of combining radioisotopes (RI) and indocyanine green (ICG) and investigate discordances in sentinel lymph node (SN) reactivity using each tracer in cN0 breast cancer patients.<br />Methods: In total, 338 cN0 primary breast cancer patients who underwent SN biopsy with RI and ICG and axillary lymph node (ALN) dissection were included. SN positivity with RI, ICG, and a combination of RI and ICG was denoted as SN(RI), SN(ICG), and SN(RI+ICG), respectively. We retrospectively estimated metastatic SN detection rates, each method's discordance rate, and the correlation of discordances in SN reactivity with postoperative N staging.<br />Results: The combination of RI and ICG had higher metastatic SN detection rates (99.7%) than RI or ICG alone (91.7% and 96.4%, respectively; p < 0.01). The discordance rate between SN(RI) and SN(ICG) in detecting metastatic SNs was 11.3% (38/337 cases). The absence of SN(RI), cT stage (cT2-3), higher histological grade (G3), and histological type (special type) were identified as risk factors of pN2-3 disease (odds ratios: 8.64, 2.56, 1.92, and 3.28, respectively; p < 0.01).<br />Conclusion: Discordances in SN reactivity between RI and ICG helps in identifying SN metastasis. Although the absence of SN(RI) is rare, it is a significant sign of advanced ALN metastases. The findings of our study indicate that ALN dissection should be considered for accurate nodal staging in such cases.<br />Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare.<br /> (Copyright © 2022 Asian Surgical Association and Taiwan Robotic Surgery Association. Published by Elsevier B.V. All rights reserved.)
- Subjects :
- Humans
Female
Indocyanine Green
Retrospective Studies
Clinical Relevance
Sentinel Lymph Node Biopsy
Lymphatic Metastasis pathology
Radioisotopes
Lymph Nodes pathology
Sentinel Lymph Node diagnostic imaging
Sentinel Lymph Node pathology
Breast Neoplasms diagnostic imaging
Breast Neoplasms surgery
Breast Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 0219-3108
- Volume :
- 46
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Asian journal of surgery
- Publication Type :
- Academic Journal
- Accession number :
- 35414456
- Full Text :
- https://doi.org/10.1016/j.asjsur.2022.03.075