Oncological outcomes and locoregional recurrence after fluorescence guided surgery for axillary staging in early breast cancer: A single UK center experience

TY - JOUR

T1 - Oncological outcomes and locoregional recurrence after fluorescence guided surgery for axillary staging in early breast cancer

T2 - A single UK center experience

AU - Kanitkar, Rahul

AU - Pitsinis, Vassilis

AU - Riaz, Bushra

AU - Vinci, Alessio

AU - Hogg, Fiona

AU - Jordan, Lee B.

N1 - Publisher Copyright: © 2025

PY - 2025/4/9

Y1 - 2025/4/9

N2 - Sentinel lymph node biopsy (SLNB) is an established standard technique for staging the axilla in clinically node-negative breast cancer patients. This study evaluates the efficacy of a dual tracer technique combining Indocyanine Green (ICG) fluorescence and blue dye for SLNB in early breast cancer patients at a single institution (Perth Royal Infirmary, Scotland). Over an eight-month period, 139 patients with clinically node-negative invasive breast cancer underwent SLNB, achieving a sentinel lymph node identification rate of 98.5 %. Among the identified nodes, a node positivity rate of 19.7 % was observed. With a median follow-up of 42 months, axillary recurrence was recorded in only 0.9 % of patients, alongside local and distant recurrences of 1.8 % and 5.5 %, respectively. The findings suggest that the ICG and blue dye technique maintains a low axillary recurrence rate comparable to traditional methods, while also addressing logistical challenges posed by the COVID-19 pandemic. This technique offers a promising alternative to radioisotope-based methods and opens new possible routes for non-radioactive axillary staging techniques. Further long-term outcomes are anticipated as the use of ICG as a sole tracer is integrated into routine practice.

AB - Sentinel lymph node biopsy (SLNB) is an established standard technique for staging the axilla in clinically node-negative breast cancer patients. This study evaluates the efficacy of a dual tracer technique combining Indocyanine Green (ICG) fluorescence and blue dye for SLNB in early breast cancer patients at a single institution (Perth Royal Infirmary, Scotland). Over an eight-month period, 139 patients with clinically node-negative invasive breast cancer underwent SLNB, achieving a sentinel lymph node identification rate of 98.5 %. Among the identified nodes, a node positivity rate of 19.7 % was observed. With a median follow-up of 42 months, axillary recurrence was recorded in only 0.9 % of patients, alongside local and distant recurrences of 1.8 % and 5.5 %, respectively. The findings suggest that the ICG and blue dye technique maintains a low axillary recurrence rate comparable to traditional methods, while also addressing logistical challenges posed by the COVID-19 pandemic. This technique offers a promising alternative to radioisotope-based methods and opens new possible routes for non-radioactive axillary staging techniques. Further long-term outcomes are anticipated as the use of ICG as a sole tracer is integrated into routine practice.

KW - Axilla

KW - Indocyanine

KW - Recurrence

KW - Sentinel node

UR - https://www.scopus.com/pages/publications/105001828284

U2 - 10.1016/j.ctarc.2025.100922

DO - 10.1016/j.ctarc.2025.100922

M3 - Article

C2 - 40188594

AN - SCOPUS:105001828284

VL - 43

JO - Cancer Treatment and Research Communications

JF - Cancer Treatment and Research Communications

M1 - 100922

ER -