Our Summary

This research paper is about a study that compared two methods of locating hard-to-feel (nonpalpable) breast cancer tumors during surgery: indocyanine green-guided and ultrasound localization.

In simple terms, the researchers looked at 78 patients who had breast cancer that couldn’t be felt by touch and who were having surgery to remove their tumors. They used the indocyanine green-guided method on 42 of these patients and the ultrasound method on the remaining 36.

They found that the indocyanine green-guided method was more effective. It resulted in clear margins (which means no cancer cells were found at the edge of the removed tissue, a good thing) in 90.5% of cases, compared to 83.3% for the ultrasound method.

Also, the indocyanine green-guided method was better at ensuring a small margin (less than 5mm) at the first attempt of removal. This was achieved in 92.9% of cases compared to 72.2% with ultrasound.

When considering the size of the removed tissue, on average, the indocyanine green-guided method removed smaller volumes (58 cubic cm), compared to ultrasound (73 cubic cm).

So, the study concludes that the indocyanine green-guided method is more accurate and efficient for nonpalpable breast cancer surgeries as it needs to remove a smaller amount of tissue without risking leaving any cancer cells behind.

FAQs

  1. What is the purpose of using indocyanine green-guided nonpalpable breast cancer lesion localization (INBCL) in lumpectomy?
  2. How does the accuracy of INBCL compare to ultrasound localization (US) in breast-conserving surgery for nonpalpable breast cancer?
  3. Does the use of INBCL in lumpectomy compromise margin status in nonpalpable lesions?

Doctor’s Tip

A helpful tip a doctor might tell a patient about lumpectomy is to consider using indocyanine green-guided nonpalpable breast cancer lesion localization (INBCL) for more accurate localization and potentially smaller volume of tissue excised, leading to better margin status. This technique may help improve the outcomes of the surgery.

Suitable For

Patients with nonpalpable breast cancer lesions who are recommended lumpectomy are typically those who have early-stage breast cancer and have small tumors that can be easily removed with a lumpectomy procedure. These patients may have undergone imaging tests such as mammograms or ultrasounds that detected the nonpalpable lesion, and their healthcare provider may have recommended lumpectomy as a treatment option. Additionally, patients who are concerned about preserving the appearance of their breast and avoiding a full mastectomy may also be recommended lumpectomy for nonpalpable breast cancer lesions.

Timeline

Before lumpectomy:

  1. Patient undergoes diagnostic tests such as mammograms, ultrasounds, and biopsies to confirm the presence of nonpalpable breast cancer.
  2. Once diagnosis is confirmed, patient and healthcare team discuss treatment options, including lumpectomy.
  3. Patient may undergo preoperative imaging studies to localize the nonpalpable lesion, such as ultrasound localization.

After lumpectomy:

  1. Patient undergoes lumpectomy procedure guided by either indocyanine green (INBCL) or ultrasound (US) localization.
  2. Following the procedure, the excised tissue is examined to determine margin status.
  3. Results show that INBCL guided excisions had a higher rate of clear margins compared to US guided excisions.
  4. INBCL guided excisions also had a higher percentage of cases with margins less than 5 mm.
  5. The mean specimen volume for INBCL guided excisions was smaller compared to US guided excisions, indicating that less tissue may be excised with the technique.
  6. Overall, the study concludes that INBCL for nonpalpable breast cancers is more accurate and may result in smaller volume of tissue excised without compromising margin status.

What to Ask Your Doctor

Some questions a patient should ask their doctor about lumpectomy may include:

  1. What is the difference between indocyanine green-guided nonpalpable breast cancer lesion localization (INBCL) and ultrasound localization (US) for lumpectomy?
  2. How does the use of INBCL compare to US in terms of achieving clear margins during surgery?
  3. What is the margin status for patients undergoing lumpectomy with INBCL versus US?
  4. How does the volume of tissue excised differ between INBCL and US-guided lumpectomies?
  5. Are there any potential risks or complications associated with using INBCL for nonpalpable breast cancer lesions?
  6. How experienced is the surgical team in performing lumpectomies using INBCL?
  7. What is the recovery process like after undergoing a lumpectomy with INBCL?
  8. How soon can I expect to receive the results of the pathology report following the lumpectomy?
  9. What follow-up care or monitoring will be necessary after the lumpectomy procedure?
  10. Are there any alternative treatment options to consider besides lumpectomy for my specific case of nonpalpable breast cancer?

Reference

Authors: Guo W, Ji W, Zhang T, Xing Z, Xing F. Journal: Surg Innov. 2022 Oct;29(5):573-578. doi: 10.1177/15533506211039962. Epub 2022 Feb 26. PMID: 35225072