J.Jpn. Surg. Soc.. 121(1): 54-60, 2020

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Feature topic

CLINICAL APPLICATION OF SENTINEL LYMPH NODE MAPPING USING FLUORESCENCE IMAGING IN EARLY-STAGE BREAST CANCER

Sentinel lymph node (SLN) biopsy is the standard of care for patients with breast cancer. SLN status leads to determination of the indications for completion of axillary node dissection and adjuvant systemic therapy. SLN biopsies using radioisotopes (RIs) show a high detection rate, and the dual method involving RIs and blue dye is considered the standard method. However, the RI method requires authorized radiation protection areas. This drawback limits SLN biopsy using RIs to high-volume medical centers. Indocyanine green (ICG) and near-infrared imaging systems visualize subcutaneous lymphatic flow and allow surgeons to observe the axillary fluorescent SLN directly. Previous studies demonstrated that the ICG fluorescence method achieved a high SLN detection rate comparable to the RI method. After being granted insurance coverage approval in 2018, the ICG fluorescence method is now another standard method for SLN mapping. Novel imaging systems using projection mapping are currently under development.

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