Skip to main content
main-content

Tipp

Weitere Artikel dieser Ausgabe durch Wischen aufrufen

Erschienen in: European Surgery 4/2017

01.08.2017 | original article

Does BMI affect the detection of sentinel lymph nodes with indocyanine green in early breast cancer patients?

verfasst von: Dr. Stephanie Rauch, Anton Haid, Zerina Jasarevic, Christoph H. Saely, Alexander Becherer, Etienne Wenzl

Erschienen in: European Surgery | Ausgabe 4/2017

Einloggen, um Zugang zu erhalten
share
TEILEN

Summary

Background

Sentinel node biopsy (SNB) has proved to be a useful and safe method for axillary staging in the surgical management of early breast cancer. Sentinel node (SN) detection rates with blue dye (patent blue) and radioisotopes (99m-Tc), either alone or particularly in combination, are high (95% to 100%). Even better detection rates were reported with fluorescent dyes like indocyanine green (ICG). This study was designed to show whether sentinel node detection and mapping of lymphatics with ICG might depend on the body mass index (BMI).

Methods

Between February 2014 and April 2015, SNB with blue dye, 99m-Tc, and ICG navigation was conducted for 100 consecutive procedures in patients scheduled for surgery of early breast cancer. ICG injection, lymphatic mapping with the Photodynamic Eye (PDE; Hamamatsu Photonics, Hamamatsu, Japan), and identification of the sentinel nodes with blue dye and ICG were followed by a final search for more lymph nodes with a gamma probe. Data were collected prospectively.

Results

In all patients, up to six sentinel nodes (mean 2.49) were detected. No statistical correlation was found between the BMI and the identification of lymphatics or the detection of lymph nodes with ICG. Lymphatics were successfully identified preoperatively in no more than 79 cases. In 6 patients, a gamma probe was needed for detection. Adverse events or allergic reactions were absent throughout.

Conclusions

SN detection and lymphatic mapping with ICG were not related to the BMI. Pending answers to as yet unsolved questions, the combined use of blue dye and 99m-Tc imaging should, however, be continued.

Sie möchten Zugang zu diesem Inhalt erhalten? Dann informieren Sie sich jetzt über unsere Produkte:

Abo für kostenpflichtige Inhalte

Literatur
1.
Zurück zum Zitat Giuliano AE, Jones RC, Brennan M, Statman R. Sentinel lymphadenectomy in breast cancer. J Clin Oncol. 1997;15(6):2345–50. CrossRefPubMed Giuliano AE, Jones RC, Brennan M, Statman R. Sentinel lymphadenectomy in breast cancer. J Clin Oncol. 1997;15(6):2345–50. CrossRefPubMed
2.
Zurück zum Zitat Krag D, Weaver D, Ashikaga T, Moffat F, Klimberg VS, Shriver C, et al. The sentinel node in breast cancer – a multicenter validation study. N Engl J Med. 1998;339(14):941–6. CrossRefPubMed Krag D, Weaver D, Ashikaga T, Moffat F, Klimberg VS, Shriver C, et al. The sentinel node in breast cancer – a multicenter validation study. N Engl J Med. 1998;339(14):941–6. CrossRefPubMed
3.
Zurück zum Zitat Veronesi U, Paganelli G, Viale G, Galimberti V, Luini A, Zurrida S, et al. Sentinel lymph node biopsy and axillary dissection in breast cancer: results in a large series. J Natl Cancer Inst. 1999;91(4):368–73. CrossRefPubMed Veronesi U, Paganelli G, Viale G, Galimberti V, Luini A, Zurrida S, et al. Sentinel lymph node biopsy and axillary dissection in breast cancer: results in a large series. J Natl Cancer Inst. 1999;91(4):368–73. CrossRefPubMed
4.
Zurück zum Zitat Haid A, Koberle-Wuhrer R, Knauer M, Burtscher J, Fritzsche H, Peschina W, et al. Morbidity of breast cancer patients following complete axillary dissection or sentinel node biopsy only: a comparative evaluation. Breast Cancer Res Treat. 2002;73(1):31–6. CrossRefPubMed Haid A, Koberle-Wuhrer R, Knauer M, Burtscher J, Fritzsche H, Peschina W, et al. Morbidity of breast cancer patients following complete axillary dissection or sentinel node biopsy only: a comparative evaluation. Breast Cancer Res Treat. 2002;73(1):31–6. CrossRefPubMed
5.
Zurück zum Zitat Purushotham AD, Upponi S, Klevesath MB, Bobrow L, Millar K, Myles JP, Duffy SW. Morbidity after sentinel lymph node biopsy in primary breast cancer: results from a randomized controlled trial. J Clin Oncol. 2005;23(19):4312–21. CrossRefPubMed Purushotham AD, Upponi S, Klevesath MB, Bobrow L, Millar K, Myles JP, Duffy SW. Morbidity after sentinel lymph node biopsy in primary breast cancer: results from a randomized controlled trial. J Clin Oncol. 2005;23(19):4312–21. CrossRefPubMed
6.
Zurück zum Zitat Cox CE, Pendas S, Cox JM, Joseph E, Shons AR, Yeatman T, et al. Guidelines for sentinel node biopsy and lymphatic mapping of patients with breast cancer. Ann Surg. 1998;227(5):645–51, discussion 651–3. CrossRefPubMedPubMedCentral Cox CE, Pendas S, Cox JM, Joseph E, Shons AR, Yeatman T, et al. Guidelines for sentinel node biopsy and lymphatic mapping of patients with breast cancer. Ann Surg. 1998;227(5):645–51, discussion 651–3. CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Sugie T, Sawada T, Tagaya N, et al. Comparison of the Indocyanine green fluorescence and blue dye methods in detection of sentinel lymph nodes in early-stage breast cancer. Ann Surg Oncol. 2012; doi: 10.​1245/​s10434-013-2890-0. Sugie T, Sawada T, Tagaya N, et al. Comparison of the Indocyanine green fluorescence and blue dye methods in detection of sentinel lymph nodes in early-stage breast cancer. Ann Surg Oncol. 2012; doi: 10.​1245/​s10434-013-2890-0.
8.
Zurück zum Zitat Ballardini B, Santoro L, Sangalli C, Gentilini O, Renne G, Lissidini G, et al. The indocyanine green method is equivalent to the 99mtc-labeled radiotracer method for identifying the sentinel node in breast cancer: a concordance and validation study. Eur J Surg Oncol. 2013;39(12):1332–6. CrossRefPubMed Ballardini B, Santoro L, Sangalli C, Gentilini O, Renne G, Lissidini G, et al. The indocyanine green method is equivalent to the 99mtc-labeled radiotracer method for identifying the sentinel node in breast cancer: a concordance and validation study. Eur J Surg Oncol. 2013;39(12):1332–6. CrossRefPubMed
9.
Zurück zum Zitat Xiong L, Gazyakan E, Yang W, Engel H, Hünerbein M, Kneser U, Hirche C. Indocyanine green fluorescence-guided sentinel node biopsy: A meta-analysis on detection rate and diagnostic performance. Eur J Surg Oncol. 2014;40(7):843–9. CrossRefPubMed Xiong L, Gazyakan E, Yang W, Engel H, Hünerbein M, Kneser U, Hirche C. Indocyanine green fluorescence-guided sentinel node biopsy: A meta-analysis on detection rate and diagnostic performance. Eur J Surg Oncol. 2014;40(7):843–9. CrossRefPubMed
10.
Zurück zum Zitat Kitai T, Inomoto T, Miwa M, Shikayama T. Fluorescence navigation with Indocyaningreen for detecting sentinel lymph nodes in breast cancer. Breast Cancer. 2005;12:211–5. CrossRefPubMed Kitai T, Inomoto T, Miwa M, Shikayama T. Fluorescence navigation with Indocyaningreen for detecting sentinel lymph nodes in breast cancer. Breast Cancer. 2005;12:211–5. CrossRefPubMed
11.
Zurück zum Zitat Grischke E‑M, Röhm C, Hahn M, Helms G, Bruckner S, Wallwiener D. ICG fluorescence technique for the detection of sentinel lymph nodes in breast cancer: results of a prospective open-label clinical trial. Geburtshilfe Frauenheilkd. 2015;75:935–40. CrossRefPubMedPubMedCentral Grischke E‑M, Röhm C, Hahn M, Helms G, Bruckner S, Wallwiener D. ICG fluorescence technique for the detection of sentinel lymph nodes in breast cancer: results of a prospective open-label clinical trial. Geburtshilfe Frauenheilkd. 2015;75:935–40. CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Samorani D, Fogacci T, Panzini I, Frisoni G, Accardi FG, Ricci M, et al. The use of indocyanine green to detect sentinel nodes in breast cancer: A prospective study. Eur J Surg Oncol. 2015;41(1):64–70. CrossRefPubMed Samorani D, Fogacci T, Panzini I, Frisoni G, Accardi FG, Ricci M, et al. The use of indocyanine green to detect sentinel nodes in breast cancer: A prospective study. Eur J Surg Oncol. 2015;41(1):64–70. CrossRefPubMed
13.
Zurück zum Zitat Hojo T, Nagao T, Kikuyama M, Akashi S, Kinoshita T. Evaluation of sentinel node biopsy by combined fluorescent and dye method and lymph flow for breast cancer. Breast. 2010;19(3):210–3. CrossRefPubMed Hojo T, Nagao T, Kikuyama M, Akashi S, Kinoshita T. Evaluation of sentinel node biopsy by combined fluorescent and dye method and lymph flow for breast cancer. Breast. 2010;19(3):210–3. CrossRefPubMed
14.
Zurück zum Zitat Veronesi U, Paganelli G, Viale G, Luini A, Zurrida S, Galimberti V, et al. A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N Engl J Med. 2003;349(6):546–53. CrossRefPubMed Veronesi U, Paganelli G, Viale G, Luini A, Zurrida S, Galimberti V, et al. A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N Engl J Med. 2003;349(6):546–53. CrossRefPubMed
15.
Zurück zum Zitat Chagpar AB, Martin RC, Scoggins CR, Carlson DJ, Laidley AL, El-Eid SE, et al. Factors predicting failure to identify a sentinel lymph node in breast cancer. Surgery. 2005;138(1):56–63. CrossRefPubMed Chagpar AB, Martin RC, Scoggins CR, Carlson DJ, Laidley AL, El-Eid SE, et al. Factors predicting failure to identify a sentinel lymph node in breast cancer. Surgery. 2005;138(1):56–63. CrossRefPubMed
16.
Zurück zum Zitat Aoyama K, Kamio T, Ohchi T, Nishizawa M, Kameoka S. Sentinel lymph node biopsy for breast cancer patients using fluorescence navigation with indocyanine green. World J Surg Oncol. 2011;9:157. CrossRefPubMedPubMedCentral Aoyama K, Kamio T, Ohchi T, Nishizawa M, Kameoka S. Sentinel lymph node biopsy for breast cancer patients using fluorescence navigation with indocyanine green. World J Surg Oncol. 2011;9:157. CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Hirano A, Kamimura M, Ogura K, Kim N, Hattori A, Setoguchi Y, et al. A comparison of indocyanine green fluorescence imaging plus blue dye and blue dye alone for sentinel node navigation surgery in breast cancer patients. Ann Surg Oncol. 2012;19(13):4112–6. CrossRefPubMed Hirano A, Kamimura M, Ogura K, Kim N, Hattori A, Setoguchi Y, et al. A comparison of indocyanine green fluorescence imaging plus blue dye and blue dye alone for sentinel node navigation surgery in breast cancer patients. Ann Surg Oncol. 2012;19(13):4112–6. CrossRefPubMed
18.
Zurück zum Zitat Takeuchi M, Sugie T, Abdelazeem K, Kato H, Shinkura N, Takada M, et al. Lymphatic mapping with fluorescence navigation using indocyanine green and axillary surgery in patients with primary breast cancer. Breast J. 2012;18(6):535–41. CrossRefPubMed Takeuchi M, Sugie T, Abdelazeem K, Kato H, Shinkura N, Takada M, et al. Lymphatic mapping with fluorescence navigation using indocyanine green and axillary surgery in patients with primary breast cancer. Breast J. 2012;18(6):535–41. CrossRefPubMed
19.
Zurück zum Zitat Tong M, Guo W, Gao W. Use of fluorescence imaging in combination with patent blue dye versus patent blue dye alone in sentinel lymph node biopsy in breast cancer. J Breast Cancer. 2014;17(3):250–5. CrossRefPubMedPubMedCentral Tong M, Guo W, Gao W. Use of fluorescence imaging in combination with patent blue dye versus patent blue dye alone in sentinel lymph node biopsy in breast cancer. J Breast Cancer. 2014;17(3):250–5. CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Wishart GC, Loh SW, Jones L, Benson JR. A feasibility study (ICG-10) of indocyanine green (ICG) fluorescence mapping for sentinel lymph node detection in early breast cancer. Eur J Surg Oncol. 2012;38(8):651–6. CrossRefPubMed Wishart GC, Loh SW, Jones L, Benson JR. A feasibility study (ICG-10) of indocyanine green (ICG) fluorescence mapping for sentinel lymph node detection in early breast cancer. Eur J Surg Oncol. 2012;38(8):651–6. CrossRefPubMed
21.
Zurück zum Zitat Schaafsma BE, Verbeek FP, Rietbergen DD, van der Hiel B, van der Vorst JR, Liefers GJ, et al. Clinical trial of combined radio- and fluorescence-guided sentinel lymph node biopsy in breast cancer. Br J Surg. 2013;100(8):1037–44. CrossRefPubMedPubMedCentral Schaafsma BE, Verbeek FP, Rietbergen DD, van der Hiel B, van der Vorst JR, Liefers GJ, et al. Clinical trial of combined radio- and fluorescence-guided sentinel lymph node biopsy in breast cancer. Br J Surg. 2013;100(8):1037–44. CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Murawa D, Hirche C, Dresel S, Hünerbein M. Sentinel lymph node biopsy in breast cancer guided by indocyanine green fluorescence. Br J Surg. 2009;96(11):1289–94. CrossRefPubMed Murawa D, Hirche C, Dresel S, Hünerbein M. Sentinel lymph node biopsy in breast cancer guided by indocyanine green fluorescence. Br J Surg. 2009;96(11):1289–94. CrossRefPubMed
23.
Zurück zum Zitat Ogasawara Y, Ikeda H, Takahashi M, Kawasaki K, Doihara H. Evaluation of breast lymphatic pathways with indocyanine green fluorescence imaging in patients with breast cancer. World J Surg. 2008;32(9):1924–9. CrossRefPubMed Ogasawara Y, Ikeda H, Takahashi M, Kawasaki K, Doihara H. Evaluation of breast lymphatic pathways with indocyanine green fluorescence imaging in patients with breast cancer. World J Surg. 2008;32(9):1924–9. CrossRefPubMed
24.
Zurück zum Zitat van der Vorst JR, Schaafsma BE, Verbeek FP, Hutteman M, Mieog JS, Lowik CW, et al. Randomized comparison of near-infrared fluorescence imaging using indocyanine green and 99(m) technetium with or without patent blue for the sentinel lymph node procedure in breast cancer patients. Ann Surg Oncol. 2012;19(13):4104–11. CrossRefPubMedPubMedCentral van der Vorst JR, Schaafsma BE, Verbeek FP, Hutteman M, Mieog JS, Lowik CW, et al. Randomized comparison of near-infrared fluorescence imaging using indocyanine green and 99(m) technetium with or without patent blue for the sentinel lymph node procedure in breast cancer patients. Ann Surg Oncol. 2012;19(13):4104–11. CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Niebling MG, Pleijhuis RG, Bastiaannet E, Brouwers AH, van Dam GM, Hoekstra HJ. A systematic review and meta-analysies o sentinel lymph node identification in breastcancer and melanoma, a plea for tracer mapping. Eur J Surg Oncol. 2016; doi: 10.​1016/​j.​ejso.​2015.​12.​007. PubMed Niebling MG, Pleijhuis RG, Bastiaannet E, Brouwers AH, van Dam GM, Hoekstra HJ. A systematic review and meta-analysies o sentinel lymph node identification in breastcancer and melanoma, a plea for tracer mapping. Eur J Surg Oncol. 2016; doi: 10.​1016/​j.​ejso.​2015.​12.​007. PubMed
Metadaten
Titel
Does BMI affect the detection of sentinel lymph nodes with indocyanine green in early breast cancer patients?
verfasst von
Dr. Stephanie Rauch
Anton Haid
Zerina Jasarevic
Christoph H. Saely
Alexander Becherer
Etienne Wenzl
Publikationsdatum
01.08.2017
Verlag
Springer Vienna
Erschienen in
European Surgery / Ausgabe 4/2017
Print ISSN: 1682-8631
Elektronische ISSN: 1682-4016
DOI
https://doi.org/10.1007/s10353-017-0480-2