Clinical Study Of Sentinel Lymph Node Biopsy Combined With Indocyanine Green And Methylene Blue For Breast Cancer

Objective: To investigate the feasibility of using indocyanine green with methylene blue in sentinel lymph node biopsy(SLNB) for breast cancer. Methods 163 cases of breast cancer patients admitted between Feb 2015 and Oct 2015 were selected,Of the patient,87 cases underwent SLNB with ICG combined with methylene blue(combined group),while 76 cases underwent SLNB with methylene blue(MB group). A Level I and II axillary lymph node dissection was performed for verfication of axilliary after SLNB for all patients. Results Two groups of basic clinical data were no statistical significance(P >0.05),were comparable.The detection rate of sentinel lymph nodes was 97.7% in the combined group and 88.2% in the MB group,and the former was higher than the latter,the difference was statistically significant(x2=5.87,P=0.015).The mean number of SLNs detected was 3.0(1-6) for the combination method and 2.1(1-4) for methylene blue alone so that the combination was significantly superior than Methylene blue group in terms of the mean number of SLNs(P=0.011). The false negative rate of the combined group is lower than that of the methylene blue group, but no significant difference between two groups in the false negative rate(x2=0.00,P=0.967). The number of SLNs detected was correlated with false negative rate,When the detected number of SLNs was less than or equal to 2, the false negative rate was 22.2%,when the number of SLNs was equal to 3 or more,the false negative rate was 2.6%,the former was significantly higher than the later(P=0.031).Conclusion The use of ICG fluorescence method combined with methylene blue staining method for breast cancer SLNB has advantages in terms of detection rate and average number of decected SLNs.the method for lymphatic real-time imaging has the prospect of application for hospital that do not have access to conventional radiation-based detection methods.