Our Summary

This research paper looks at a new method for identifying the status of breast tumors in patients. Currently, doctors use a procedure involving blue dye to find and analyze sentinel lymph nodes (SLNs), which are the first few lymph nodes into which a tumor drains, and this can help determine the stage of the cancer. However, this study has looked at using a substance called indocyanine green (ICG) instead.

The researchers tested both methods on 39 patients. They found that all 84 lymph nodes analyzed could be identified using ICG, while only 37 could be identified using the blue dye. Therefore, ICG was able to detect more SLNs per patient than the blue dye.

The study concludes that ICG is a safe and effective method for locating sentinel lymph nodes in breast cancer patients, and is superior to the blue dye method. This could mean that ICG could be a better option for use in clinical settings where currently only blue dye is used.

FAQs

  1. What is the new method for identifying the status of breast tumors in patients?
  2. How does the effectiveness of indocyanine green (ICG) compare to the current blue dye method in locating sentinel lymph nodes (SLNs)?
  3. Could indocyanine green (ICG) be a better option for use in clinical settings than the current blue dye method?

Doctor’s Tip

A doctor might tell a patient that using indocyanine green (ICG) for sentinel lymph node biopsy can be more effective in identifying lymph nodes compared to the traditional blue dye method. This can help in accurately staging the cancer and determining the best treatment plan. It is important for patients to discuss with their healthcare provider about the potential benefits and risks of using ICG for their specific situation.

Suitable For

Patients who are typically recommended for sentinel lymph node biopsy include those with early-stage breast cancer, particularly those with invasive ductal carcinoma or invasive lobular carcinoma. Additionally, patients with a tumor size of less than 5 centimeters, no evidence of metastasis to other parts of the body, and no previous chemotherapy or radiation therapy may also be candidates for this procedure. Sentinel lymph node biopsy is used to determine if the cancer has spread to nearby lymph nodes, which can help guide further treatment decisions.

Timeline

  • Before the sentinel lymph node biopsy:
  1. Patient is diagnosed with breast cancer and recommended for a sentinel lymph node biopsy to determine the stage of the cancer.
  2. Patient discusses the procedure with their healthcare provider and any potential risks or side effects.
  3. Patient may undergo imaging tests such as a lymphoscintigraphy to map the lymph nodes that will be targeted during the biopsy.
  4. Patient may receive instructions on fasting before the procedure and any necessary preparations.
  • During the sentinel lymph node biopsy:
  1. Patient is given a local anesthetic to numb the area where the lymph nodes will be removed.
  2. Blue dye or indocyanine green is injected near the tumor to help locate the sentinel lymph nodes.
  3. Surgeon uses a special probe or imaging device to locate and remove the sentinel lymph nodes.
  4. The removed lymph nodes are sent to a lab for analysis to determine if cancer cells are present.
  • After the sentinel lymph node biopsy:
  1. Patient is monitored for any immediate side effects or complications from the procedure.
  2. Results from the biopsy are typically available within a few days to a week.
  3. Patient meets with their healthcare provider to discuss the results and determine the next steps in their treatment plan.
  4. Depending on the results, additional treatments such as surgery, chemotherapy, or radiation therapy may be recommended.

What to Ask Your Doctor

  1. What is a sentinel lymph node biopsy and why is it necessary for my treatment?
  2. What are the risks and potential complications associated with a sentinel lymph node biopsy?
  3. How is indocyanine green (ICG) different from the traditional blue dye method for locating sentinel lymph nodes?
  4. What are the benefits of using ICG over the blue dye method for sentinel lymph node biopsy?
  5. How accurate is ICG in identifying sentinel lymph nodes compared to the blue dye method?
  6. Will I need to undergo any additional procedures or tests if I choose to have an ICG-guided sentinel lymph node biopsy?
  7. Are there any specific factors that make me a better candidate for an ICG-guided sentinel lymph node biopsy?
  8. How long will it take to receive the results from the biopsy using ICG?
  9. What is the typical recovery time and follow-up care needed after an ICG-guided sentinel lymph node biopsy?
  10. Are there any ongoing studies or research regarding the use of ICG in sentinel lymph node biopsy that I should be aware of?

Reference

Authors: Lin J, Lin LS, Chen DR, Lin KJ, Wang YF, Chang YJ. Journal: Asian J Surg. 2020 Dec;43(12):1149-1153. doi: 10.1016/j.asjsur.2020.02.003. Epub 2020 Mar 3. PMID: 32143963