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Benoit L, de Thorey AG, David MG, Azais H, Bentivegna E, Nguyen-Xuan HT, Simon V, Achen G, Bats AS, Koual M. Clinical use of Indocyanine green fluorescence method for sentinel lymph node biopsy in breast cancer in France in 2021. J Gynecol Obstet Hum Reprod 2024; 53:102703. [PMID: 38040334 DOI: 10.1016/j.jogoh.2023.102703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/17/2023] [Accepted: 11/23/2023] [Indexed: 12/03/2023]
Abstract
INTRODUCTION Indocyanine green (ICG) for axillary sentinel lymph node (SLN) detection in early breast cancer is at least equivalent to radioisotopic and/or colorimetric techniques. This procedure has not yet been recommended by learned societies in France. Following the recent drug approval of Infracyanin ® in this indication, we wished to study the use of ICG in France. METHODS We conducted a web-based survey among members of multiple French breast cancer societies throughout November 2021. The survey assessed the profile of the respondent, the use or not of ICG for the detection of SLN in breast cancer, the technique used and the opinion of non-users and their expectations on the subject. RESULTS Seventy-five surgeons participated. More than a third (37 %) have been using ICG for the detection of SLN in breast cancer for 2 to 3 years. Technique was highly variable. According to 82.1 % of the respondents, less than 20 procedures are necessary to master the use of ICG. The main advantage reported for this method is the reduction of organizational constraints. The obstacles to the use of the ICG are the near infra-red camera equipment, but also the lack of validation by the French guidelines. Among non-users, 83 % would like to develop this technique in their center and 72.3 % are interested in training on this subject. CONCLUSION This work highlights the need for French learned societies to take a stand on this issue but also the need to carry out studies on the technical aspects in order to standardise practices.
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Affiliation(s)
- Louise Benoit
- Service de chirurgie gynécologique de l'Hôpital Européen Georges Pompidou, France; Université de Paris Cité, France; INSERM UMR-S 1124, Université de Paris, Centre Universitaire des Saints-Pères, Paris, France.
| | | | - Manuel Gomes David
- Surgery Department, Institut de Cancérologie de Lorraine, 6, Avenue de Bourgogne, 54519 Vandoeuvre-les-Nancy, France
| | - Henri Azais
- Service de chirurgie gynécologique de l'Hôpital Européen Georges Pompidou, France; Université de Paris Cité, France; INSERM UMR-S 1147, Université de Paris, Centre Universitaire des Saints-Pères, Paris, France
| | - Enrica Bentivegna
- Service de chirurgie gynécologique de l'Hôpital Européen Georges Pompidou, France
| | | | - Vanille Simon
- Service de chirurgie gynécologique de l'Hôpital Européen Georges Pompidou, France; Université de Paris Cité, France
| | - Guillaume Achen
- Service de chirurgie gynécologique de l'Hôpital Européen Georges Pompidou, France; Université de Paris Cité, France
| | - Anne-Sophie Bats
- Service de chirurgie gynécologique de l'Hôpital Européen Georges Pompidou, France; Université de Paris Cité, France; INSERM UMR-S 1147, Université de Paris, Centre Universitaire des Saints-Pères, Paris, France
| | - Meriem Koual
- Service de chirurgie gynécologique de l'Hôpital Européen Georges Pompidou, France; Université de Paris Cité, France; INSERM UMR-S 1124, Université de Paris, Centre Universitaire des Saints-Pères, Paris, France
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Rocco N, Velotti N, Pontillo M, Vitiello A, Berardi G, Accurso A, Masone S, Musella M. New techniques versus standard mapping for sentinel lymph node biopsy in breast cancer: a systematic review and meta-analysis. Updates Surg 2023; 75:1699-1710. [PMID: 37326934 PMCID: PMC10435404 DOI: 10.1007/s13304-023-01560-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/03/2023] [Indexed: 06/17/2023]
Abstract
New tracers for sentinel lymph node biopsy (SLNB), as indocyanine green (ICG), superparamagnetic iron oxide (SPIO) and micro bubbles, have been recently introduced in clinical practice showing promising but variable results. We reviewed the available evidence comparing these new techniques with the standard tracers to evaluate their safety. To identify all available studies, a systematic search was performed in all electronic databases. Data regarding sample size, mean number of SLN harvested for patient, number of metastatic SLN and SLN identification rate of all studies were extracted. No significant differences were found in terms of SLNs identification rates between SPIO, RI and BD but with a higher identification rate with the use of ICG. No significant differences were also found for the number of metastatic lymph nodes identified between SPIO, RI and BD and the mean number of SLNs identified between SPIO and ICG versus conventional tracers. A statistically significant differences in favor of ICG was reported for the comparison between ICG and conventional tracers for the number of metastatic lymph nodes identified. Our meta-analysis demonstrates that the use of both ICG and SPIO for the pre-operative mapping of sentinel lymph nodes in breast cancer treatment is adequately effective.
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Affiliation(s)
- Nicola Rocco
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Nunzio Velotti
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy.
| | - Martina Pontillo
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Antonio Vitiello
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Giovanna Berardi
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Antonello Accurso
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Stefania Masone
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy
| | - Mario Musella
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
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Małkiewicz B, Kiełb P, Kobylański M, Karwacki J, Poterek A, Krajewski W, Zdrojowy R, Szydełko T. Sentinel Lymph Node Techniques in Urologic Oncology: Current Knowledge and Application. Cancers (Basel) 2023; 15:cancers15092495. [PMID: 37173960 PMCID: PMC10177100 DOI: 10.3390/cancers15092495] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 04/23/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
Lymph node (LN) metastases have a significant negative impact on the prognosis of urological malignancies. Unfortunately, current imaging modalities are insufficient when it comes to detecting micrometastases; thus, surgical LN removal is commonly used. However, there is still no established ideal lymph node dissection (LND) template, leading to unnecessary invasive staging and the possibility of missing LN metastases located outside the standard template. To address this issue, the sentinel lymph node (SLN) concept has been proposed. This technique involves identifying and removing the first group of draining LNs, which can accurately stage cancer. While successful in breast cancer and melanoma, the SLN technique in urologic oncology is still considered experimental due to high false-negative rates and lack of data in prostate, bladder, and kidney cancer. Nevertheless, the development of new tracers, imaging modalities, and surgical techniques may improve the potential of the SLN procedures in urological oncology. In this review, we aim to discuss the current knowledge and future contributions of the SLN procedure in the management of urological malignancies.
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Affiliation(s)
- Bartosz Małkiewicz
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Paweł Kiełb
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Maximilian Kobylański
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Jakub Karwacki
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Adrian Poterek
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Wojciech Krajewski
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Romuald Zdrojowy
- University Center of Excellence in Urology, Department of Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Tomasz Szydełko
- University Center of Excellence in Urology, Department of Minimally Invasive and Robotic Urology, Wroclaw Medical University, 50-556 Wroclaw, Poland
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Lin SE, Chang WW, Hsiao PK, Hsieh MC, Chen WY, Fang CL, Tsai CC. Feasibility of Breast Cancer Metastasis Assessment of Ex Vivo Sentinel Lymph Nodes through a p-H&E Optical Coherence Microscopic Imaging System. Cancers (Basel) 2022; 14:cancers14246081. [PMID: 36551567 PMCID: PMC9776820 DOI: 10.3390/cancers14246081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/21/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
Frozen-sectioned hematoxylin-eosin (H&E) image evaluation is the current method for intraoperative breast cancer metastasis assessment through ex vivo sentinel lymph nodes (SLNs). After frozen sectioning, the sliced fatty region of the frozen-sectioned specimen is easily dropped because of different freezing points for fatty tissues and other tissues. Optical-sectioned H&E images provide a nondestructive method for obtaining the insight en face image near the attached surface of the dissected specimen, preventing the freezing problem of fatty tissue. Specimens from 29 patients at Wanfang Hospital were collected after excision and were analyzed at the pathology laboratory, and a fluorescence-in-built optical coherence microscopic imaging system (OCMIS) was then used to visualize the pseudo-H&E (p-H&E) images of the SLNs for intraoperative breast cancer metastasis assessment, and the specificity, sensitivity, and accuracy were 100%, 88.9%, and 98.8% (n = 83), respectively. Compared with gold-standard paraffin-sectioned H&E images, the specificity, sensitivity, and accuracy obtained with the frozen-sectioned H&E images (n = 85) of the specimens were the same as those obtained with the p-H&E images (n = 95). Thus, OCMIS is a useful noninvasive image-assisted tool for breast cancer metastasis assessment based on SLN images.
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Affiliation(s)
- Sey-En Lin
- Department of Anatomic Pathology, New Taipei Municipal Tucheng Hospital (Built and Operated by Chang Gung Medical Foundation), New Taipei City 23652, Taiwan
- Department of Pathology, Taipei Medical University Hospital, Taipei Medical University, Taipei 11031, Taiwan
- Department of Pathology, Wanfang Hospital, Taipei Medical University, Taipei 11696, Taiwan
| | - Wei-Wen Chang
- Division of General Surgery, Department of Surgery, Wanfang Hospital, Taipei Medical University, Taipei 11696, Taiwan
| | - Ping-Kun Hsiao
- Division of General Surgery, Department of Surgery, Wanfang Hospital, Taipei Medical University, Taipei 11696, Taiwan
| | - Mao-Chih Hsieh
- Division of General Surgery, Department of Surgery, Wanfang Hospital, Taipei Medical University, Taipei 11696, Taiwan
| | - Wei-Yu Chen
- Department of Pathology, Wanfang Hospital, Taipei Medical University, Taipei 11696, Taiwan
| | - Chia-Lang Fang
- Department of Pathology, Taipei Medical University Hospital, Taipei Medical University, Taipei 11031, Taiwan
- Department of Pathology, Wanfang Hospital, Taipei Medical University, Taipei 11696, Taiwan
| | - Chien-Chung Tsai
- AcuSolutions Inc., 3F., No. 2, Ln. 263, Chongyang Rd., Nangang Dist., Taipei 11573, Taiwan
- Correspondence: ; Tel.: +886-2-2558-9611
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5
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The Application of Magnetic Nanoparticles for Sentinel Lymph Node Detection in Clinically Node-Negative Breast Cancer Patients: A Systemic Review and Meta-Analysis. Cancers (Basel) 2022; 14:cancers14205034. [PMID: 36291818 PMCID: PMC9599783 DOI: 10.3390/cancers14205034] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 11/30/2022] Open
Abstract
Superparamagnetic iron oxide (SPIO), an alternative mapping agent, can be used to identify sentinel lymph nodes in patients with clinically node-negative breast cancer. However, its performance in comparison with the standard method, using a radioisotope (technetium-99 m, Tc) alone or in combination with blue dye, remains controversial. Hence, a systematic review and meta-analysis were conducted to evaluate the diagnostic accuracy of SPIO and its clinical impact in the management of breast cancer. The PubMed, Embase, and Cochrane databases were comprehensively searched from inception to 1 May 2022. Cohort studies regarding the comparison of SPIO with standard methods for sentinel lymph node identification were included. A total of 19 prospective cohort studies, which collectively included 2298 clinically node-negative breast cancer patients undergoing sentinel lymph node identification through both the standard method and SPIO, were identified. The detection rate for sentinel lymph nodes (RR, 1.06; 95% CI, 1.05−1.08; p < 0.001) was considerably higher in the SPIO cohorts than in the standard method cohorts, although this difference was not significant in detected patients, patients with positive sentinel lymph nodes, or positive sentinel lymph nodes. Compared with the standard method, the SPIO method could be considered as an alternative standard of care for sentinel lymph node detection in patients with clinically node-negative breast cancer.
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Bavali A, Amani M. LIF spectroscopy of epithelial tissues: Assay of structural changeover due to the cancer progression. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2022; 233:112482. [PMID: 35660311 DOI: 10.1016/j.jphotobiol.2022.112482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 05/11/2022] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
Most of the human cancers occur in epithelial tissues containing basic cells with different shapes, and not only do the spectral properties of the tissue pigments alter due to cancer, but the cellular architecture also change. However, in optical diagnosis of the cancerous tissues, attention has been paid to the spectral changeover of native chromophores as bio-markers. Here, we have attempted to assay the structural alterations of the epithelial tissues during the cancer progression utilizing Laser induced fluorescence (LIF) spectroscopy as a fast, sensitive and easy-to-use method. In this regard, angular dependence of the LIF spectral features of the healthy and cancerous epithelial tissues (soaked in Rhodamine 6G solution) from three different human organs i. e. uterus, colon and kidney with distinct microstructures have been examined. In general, both wavelength and intensity at the peak of the LIF spectra depend on the tissue orientation and the angle of detection respect to the laser beam direction. Those optical parameters also demonstrate distinctive alterations in different tissues that is explicated based on the morphological alteration of the epithelial cells in each carcinoma type provided by pathology data.
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Affiliation(s)
- Ali Bavali
- Department of Energy Engineering and Physics, Amirkabir University of Technology (Tehran Polytechnic), Iran.
| | - Marzieh Amani
- Department of Energy Engineering and Physics, Amirkabir University of Technology (Tehran Polytechnic), Iran
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7
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Subhan MA, Muzibur Rahman M. Recent Development in Metallic Nanoparticles for Breast Cancer Therapy and Diagnosis. CHEM REC 2022; 22:e202100331. [PMID: 35146897 DOI: 10.1002/tcr.202100331] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/30/2022] [Indexed: 12/25/2022]
Abstract
Metal-based nanoparticles are very promising for their applications in cancer diagnosis, drug delivery and therapy. Breast cancer is the major reason of death in woman especially in developed countries including EU and USA. Due to the heterogeneity of cancer cells, nanoparticles are effective as therapeutics and diagnostics. Anti-cancer therapy of breast tumors is challenging because of highly metastatic progression of the disease to brain, bone, lung, and liver. Magnetic nanoparticles are crucial for metastatic breast cancer detection and protection. This review comprehensively discusses the application of nanomaterials as breast cancer therapy, therapeutics, and diagnostics.
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Affiliation(s)
- Md Abdus Subhan
- Department of Chemistry, School of Physical Sciences, Shah Jalal University of Science and Technology, 3114, Sylhet, Bangladesh
| | - Mohammed Muzibur Rahman
- Center of Excellence for Advanced Materials Research (CEAMR) & Department of Chemistry, Faculty of Science, King Abdulaziz University, P.O. Box 80203, 21589, Jeddah, Saudi Arabia
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8
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Sottani C, Grignani E, Cottica D, Mazzucchelli S, Sevieri M, Chesi A, Corsi F, Galfrè S, Robustelli Della Cuna FS, Calleri E. Development and Validation of a Bioanalytical UHPLC-MS/MS Method Applied to Murine Liver Tissue for the Determination of Indocyanine Green Loaded in H-Ferritin Nanoparticles. Front Chem 2022; 9:784123. [PMID: 35047479 PMCID: PMC8762227 DOI: 10.3389/fchem.2021.784123] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/19/2021] [Indexed: 11/13/2022] Open
Abstract
Indocyanine green (ICG) is one of the most commonly used fluorophores in near-infrared fluorescence-guided techniques. However, the molecule is prone to form aggregates in saline solution with a limited photostability and a moderate fluorescence yield. ICG was thus formulated using protein-based nanoparticles of H-ferritin (HFn) in order to generate a new nanostructure, HFn-ICG. In this study, an ultrahigh performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) system was employed to develop and validate the quantitative analysis of ICG in liver tissue samples from HFn-ICG-treated mice. To precipitate HFn, cold acetone in acidic solution at pH 5.0 was used. The processed liver samples were injected into the UHPLC-MS/MS system for analysis using the positive electrospray ionization mode. Chromatographic separation was achieved on a Waters Acquity UPLC® HSS T3 Column (1.8 μm, 2.1 × 100 mm) with 0.1% formic acid and acetonitrile as the mobile phase with gradient elution. The selected reaction monitoring transitions of m / z 753 → m / z 330 and m / z 827 → m / z 330 were applied for ICG and IR-820 (the internal standard, IS), respectively. The method was selective and linear over a concentration range of 50-1,500 ng/ml. The method was validated for sensitivity, accuracy, precision, extraction recovery, matrix effect, and stability in liver tissue homogenates. ICG extraction recoveries ranged between 85 and 108%. The intra- and inter-day precisions were less than 6.28%. The method was applied to a bio-distribution study to compare the amount of ICG levels from mice treated with HFn-ICG and free ICG. The analyses of the homogenate samples from the two types of treatment showed that the concentration levels of ICG is approximately six-fold higher than those of free ICG (1,411 ± 7.62 ng/ml vs. 235 ± 26.0 ng/ml) at 2 h post injection.
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Affiliation(s)
- Cristina Sottani
- Environmental Research Center, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Elena Grignani
- Environmental Research Center, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Danilo Cottica
- Environmental Research Center, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Serena Mazzucchelli
- Nanomedicine Laboratory, Department of Biomedical and Clinical Sciences "Luigi Sacco", Milano University, Milan, Italy
| | - Marta Sevieri
- Nanomedicine Laboratory, Department of Biomedical and Clinical Sciences "Luigi Sacco", Milano University, Milan, Italy
| | - Arianna Chesi
- Nanomedicine Laboratory, Department of Biomedical and Clinical Sciences "Luigi Sacco", Milano University, Milan, Italy
| | - Fabio Corsi
- Nanomedicine Laboratory, Department of Biomedical and Clinical Sciences "Luigi Sacco", Milano University, Milan, Italy.,Breast Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Sarah Galfrè
- Department of Drug Sciences, University of Pavia, Pavia, Italy
| | | | - Enrica Calleri
- Department of Drug Sciences, University of Pavia, Pavia, Italy
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Mazumdar A, Jain S, Jain S, Bose SM. Management of Early Breast Cancer – Surgical Aspects. Breast Cancer 2022. [DOI: 10.1007/978-981-16-4546-4_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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10
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Deng B, Wang Y, Wu Y, Yin W, Lu J, Ye J. Raman Nanotags-Guided Intraoperative Sentinel Lymph Nodes Precise Location with Minimal Invasion. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2022; 9:e2102405. [PMID: 34741446 PMCID: PMC8805599 DOI: 10.1002/advs.202102405] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/13/2021] [Indexed: 06/13/2023]
Abstract
The accurate positioning of sentinel lymph node (SLN) by tracers during surgery is an important prerequisite for SLN biopsy. A major problem of traditional tracers in SLN biopsy is the short surgery window due to the fast diffusion of tracers through the lymphatics, resulting in a misjudgment between SLN and second echelon lymph node (2nd LN). Here, a nontoxic Raman nanoparticle tracer, termed gap-enhanced Raman tags (GERTs), for the accurate intraoperative positioning of SLNs with a sufficient surgical time window is designed. In white New Zealand rabbit models, GERTs enable precise identification of SLNs within 10 min, as well as provide the surgeon with a more than 4 h time window to differentiate SLN and 2nd LN. In addition, the ultrahigh sensitivity of GERTs (detection limit is 0.5 × 10-12 m) allows detection of labeled SLNs before surgery, thereby providing preoperative positioning information for minimally invasive surgery. Comprehensive biosafety evaluations carried out in the context of the Food and Drug Administration and International Standard Organization demonstrate no significant toxicity of GERTs, which supports a promising clinical translation opportunity of GERTs for precise SLN identification in breast cancer.
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Affiliation(s)
- Binge Deng
- State Key Laboratory of Oncogenes and Related GenesSchool of Biomedical EngineeringShanghai Jiao Tong UniversityShanghai200030P. R. China
| | - Yaohui Wang
- Department of Breast SurgeryRenji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai200127P. R. China
| | - Yifan Wu
- Department of Breast SurgeryRenji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai200127P. R. China
| | - Wenjin Yin
- Department of Breast SurgeryRenji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai200127P. R. China
| | - Jinsong Lu
- Department of Breast SurgeryRenji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai200127P. R. China
| | - Jian Ye
- State Key Laboratory of Oncogenes and Related GenesSchool of Biomedical EngineeringShanghai Jiao Tong UniversityShanghai200030P. R. China
- Shanghai Key Laboratory of Gynecologic OncologyRenji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai200127P. R. China
- Institute of Medical RoboticsShanghai Jiao Tong UniversityShanghai200240P. R. China
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Franceschini G, Mason EJ, Franco A, Masetti R. Surgical treatment of breast cancer. Minerva Surg 2021; 76:495-497. [PMID: 34935319 DOI: 10.23736/s2724-5691.21.09155-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Gianluca Franceschini
- IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy - .,Breast Unit, Department of Woman and Child Health and Public Health, Sacred Heart Catholic University, Rome, Italy -
| | - Elena J Mason
- IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy.,Breast Unit, Department of Woman and Child Health and Public Health, Sacred Heart Catholic University, Rome, Italy
| | - Antonio Franco
- IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy.,Breast Unit, Department of Woman and Child Health and Public Health, Sacred Heart Catholic University, Rome, Italy
| | - Riccardo Masetti
- IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy.,Breast Unit, Department of Woman and Child Health and Public Health, Sacred Heart Catholic University, Rome, Italy
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Tagiling N, Yahya MM, Wan Zain WZ, Wan Abdul Rahman WF, Mat Nawi N. Early Institutional Experience of Dual Tracer and Single-Photon Emission Computed-Tomography/Computed-Tomography Mapping for Sentinel Node Biopsy: A Report of Two Early-Stage Breast Cancer. PROCEEDINGS OF SINGAPORE HEALTHCARE 2021. [DOI: 10.1177/20101058211057328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Intraoperative sentinel lymph node mapping (SLNM) with methylene blue dye (MBD) tracer has been the recommended method to detect SLN in early-stage breast cancer patients in low-resource settings. However, the use of MBD alone is hampered by the high false-negative rate; thus, it requires coupling with other mapping methods if the appropriate infrastructure and services are available. In this article, we present two prospective cases detailing our initial experience using the gold-standard dual tracer technique (DTT: MBD and 99mTc-nanocolloid radioisotope) in combination with hybrid single-photon emission computed-tomography/computed-tomography (SPECT/CT) preoperative mapping for image-guided SLN biopsy (SLNB). Overall, both studies were successful in identifying the SLNs, which aided in mapping the possible anatomical spread of the disease.
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Affiliation(s)
- Nashrulhaq Tagiling
- Department of Nuclear Medicine, Radiotherapy and Oncology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Maya Mazuwin Yahya
- Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
- Breast Cancer Awareness and Research Unit (BESTARI), Hospital USM, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Wan Zainira Wan Zain
- Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
- Breast Cancer Awareness and Research Unit (BESTARI), Hospital USM, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Wan Faiziah Wan Abdul Rahman
- Department of Pathology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
- Hospital USM, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Norazlina Mat Nawi
- Department of Nuclear Medicine, Radiotherapy and Oncology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
- Hospital USM, Universiti Sains Malaysia, Kelantan, Malaysia
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Kedrzycki MS, Leiloglou M, Ashrafian H, Jiwa N, Thiruchelvam PTR, Elson DS, Leff DR. Meta-analysis Comparing Fluorescence Imaging with Radioisotope and Blue Dye-Guided Sentinel Node Identification for Breast Cancer Surgery. Ann Surg Oncol 2021; 28:3738-3748. [PMID: 33156466 PMCID: PMC8184731 DOI: 10.1245/s10434-020-09288-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/27/2020] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Conventional methods for axillary sentinel lymph node biopsy (SLNB) are fraught with complications such as allergic reactions, skin tattooing, radiation, and limitations on infrastructure. A novel technique has been developed for lymphatic mapping utilizing fluorescence imaging. This meta-analysis aims to compare the gold standard blue dye and radioisotope (BD-RI) technique with fluorescence-guided SLNB using indocyanine green (ICG). METHODS This study was registered with PROSPERO (CRD42019129224). The MEDLINE, EMBASE, Scopus, and Web of Science databases were searched using the Medical Subject Heading (MESH) terms 'Surgery' AND 'Lymph node' AND 'Near infrared fluorescence' AND 'Indocyanine green'. Studies containing raw data on the sentinel node identification rate in breast cancer surgery were included. A heterogeneity test (using Cochran's Q) determined the use of fixed- or random-effects models for pooled odds ratios (OR). RESULTS Overall, 1748 studies were screened, of which 10 met the inclusion criteria for meta-analysis. ICG was equivalent to radioisotope (RI) at sentinel node identification (OR 2.58, 95% confidence interval [CI] 0.35-19.08, p < 0.05) but superior to blue dye (BD) (OR 9.07, 95% CI 6.73-12.23, p < 0.05). Furthermore, ICG was superior to the gold standard BD-RI technique (OR 4.22, 95% CI 2.17-8.20, p < 0.001). CONCLUSION Fluorescence imaging for axillary sentinel node identification with ICG is equivalent to the single technique using RI, and superior to the dual technique (RI-BD) and single technique with BD. Hospitals using RI and/or BD could consider changing their practice to ICG given the comparable efficacy and improved safety profile, as well as the lesser burden on hospital infrastructure.
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Affiliation(s)
- Martha S Kedrzycki
- Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, London, UK. .,Department of Surgery and Cancer, Imperial College London, London, UK. .,Department of Breast Surgery, Imperial Healthcare Trust, London, UK.
| | - Maria Leiloglou
- Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, London, UK.,Department of Surgery and Cancer, Imperial College London, London, UK
| | - Hutan Ashrafian
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Natasha Jiwa
- Department of Surgery and Cancer, Imperial College London, London, UK.,Department of Breast Surgery, Imperial Healthcare Trust, London, UK
| | - Paul T R Thiruchelvam
- Department of Surgery and Cancer, Imperial College London, London, UK.,Department of Breast Surgery, Imperial Healthcare Trust, London, UK
| | - Daniel S Elson
- Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, London, UK.,Department of Surgery and Cancer, Imperial College London, London, UK
| | - Daniel R Leff
- Department of Surgery and Cancer, Imperial College London, London, UK.,Department of Breast Surgery, Imperial Healthcare Trust, London, UK
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Bhushan A, Gonsalves A, Menon JU. Current State of Breast Cancer Diagnosis, Treatment, and Theranostics. Pharmaceutics 2021; 13:723. [PMID: 34069059 PMCID: PMC8156889 DOI: 10.3390/pharmaceutics13050723] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 12/11/2022] Open
Abstract
Breast cancer is one of the leading causes of cancer-related morbidity and mortality in women worldwide. Early diagnosis and effective treatment of all types of cancers are crucial for a positive prognosis. Patients with small tumor sizes at the time of their diagnosis have a significantly higher survival rate and a significantly reduced probability of the cancer being fatal. Therefore, many novel technologies are being developed for early detection of primary tumors, as well as distant metastases and recurrent disease, for effective breast cancer management. Theranostics has emerged as a new paradigm for the simultaneous diagnosis, imaging, and treatment of cancers. It has the potential to provide timely and improved patient care via personalized therapy. In nanotheranostics, cell-specific targeting moieties, imaging agents, and therapeutic agents can be embedded within a single formulation for effective treatment. In this review, we will highlight the different diagnosis techniques and treatment strategies for breast cancer management and explore recent advances in breast cancer theranostics. Our main focus will be to summarize recent trends and technologies in breast cancer diagnosis and treatment as reported in recent research papers and patents and discuss future perspectives for effective breast cancer therapy.
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Affiliation(s)
- Arya Bhushan
- Ladue Horton Watkins High School, St. Louis, MO 63124, USA;
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, Kingston, RI 02881, USA;
| | - Andrea Gonsalves
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, Kingston, RI 02881, USA;
| | - Jyothi U. Menon
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, Kingston, RI 02881, USA;
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15
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Hamdy O, Farouk O, El-Badrawy A, Denewer A, Setit A. Sentinel lymph node biopsy in breast cancer guided by CT lymphography; History, evolution and current applications. Breast Dis 2021; 40:219-225. [PMID: 33935052 DOI: 10.3233/bd-201046] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Sentinel lymph node biopsy (SLNB) has efficiently replaced axillary lymph node dissection (ALND) in axillary staging in node-negative breast cancer patients. Dual sentinel lymph node (SLN) localization using radioisotopes and blue dye is the standard technique for SLN mapping. Yet, nuclear medicine facilities are not widely available worldwide. In Japan, Computed tomography lymphography (CTLG) is presented as an SLN mapping technique which was first suggested in 2003 by Suga et al. Multiple subsequent studies confirmed the efficacy of CTLG in SLN mapping in breast cancer. Further applications of the technique followed; such as prediction of SLN metastasis using CTLG, the use of CTLG guided SLN biopsy after neoadjuvant therapy, video-assisted CTLG guided SLN biopsy, the use of real-time virtual sonography with 3-D CTLG, and preoperative localization of the CTLG mapped SLN using either real-time virtual sonography (RVS) guided Indocyanine green (ICG) injection or its marking using liquid charcoal and silver wire and the use of SPIO enhanced magnetic resonance imaging (MRI) for prediction of metastasis in SLNs detected by CTLG. This efficacy and variable applications open the door for conducting wide-scale randomized controlled trials to suggest using CTLG as an efficient alternative for the use of radioisotopes in SLN mapping in breast cancer patients, especially in low and middle-income countries.
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Affiliation(s)
- Omar Hamdy
- Surgical Oncology Unit, Oncology Center, Mansoura University, Mansoura, Egypt
| | - Omar Farouk
- Surgical Oncology Unit, Oncology Center, Mansoura University, Mansoura, Egypt
| | - Adel El-Badrawy
- Radiology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Adel Denewer
- Surgical Oncology Unit, Oncology Center, Mansoura University, Mansoura, Egypt
| | - Ahmed Setit
- Surgical Oncology Unit, Oncology Center, Mansoura University, Mansoura, Egypt
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16
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Sentinel Node Biopsy after Neoadjuvant Chemotherapy for Breast Cancer: Preliminary Experience with Clinically Node Negative Patients after Systemic Treatment. J Pers Med 2021; 11:jpm11030172. [PMID: 33801435 PMCID: PMC7998155 DOI: 10.3390/jpm11030172] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/20/2021] [Accepted: 02/22/2021] [Indexed: 02/06/2023] Open
Abstract
Sentinel lymph node biopsy (SLNB) following neoadjuvant treatment (NACT) has been questioned by many studies that reported heterogeneous identification (IR) and false negative rates (FNR). As a result, some patients receive axillary lymph node dissection (ALND) regardless of response to NACT, leading to a potential overtreatment. To better assess reliability and clinical significance of SLNB status on ycN0 patients, we retrospectively analyzed oncological outcomes of 399 patients treated between January 2016 and December 2019 that were either cN0-ycN0 (219 patients) or cN1/2-ycN0 (180 patients). The Endpoints of our study were to assess, furthermore than IR: oncological outcomes as Overall Survival (OS); Distant Disease Free Survival (DDFS); and Regional Disease Free Survival (RDFS) according to SLNB status. SLN identification rate was 96.8% (98.2% in patients cN0-ycN0 and 95.2% in patients cN+-ycN0). A median number of three lymph nodes were identified and removed. Among cN0-ycN0 patients, 149 (68%) were confirmed ypN0(sn), whereas regarding cN1/2-ycN0 cases 86 (47.8%) confirmed an effective downstaging to ypN0. Three year OS, DDFS and RDFS were significantly related to SLNB positivity. Our data seemed to confirm SLNB feasibility following NACT in ycN0 patients, furthermore reinforcing its predictive role in a short observation timing.
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17
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Staubach P, Scharl A, Ignatov A, Ortmann O, Inwald EC, Hildebrandt T, Gerken M, Klinkhammer-Schalke M, Scharl S, Papathemelis T. Sentinel lymph node detection by means of indocyanine green using the Karl Storz VITOM ® fluorescence camera: a comparison between primary sentinel lymph node biopsy versus sentinel lymph node biopsy after neoadjuvant chemotherapy. J Cancer Res Clin Oncol 2020; 147:1813-1823. [PMID: 33230583 DOI: 10.1007/s00432-020-03461-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/06/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE The usage of radioactive Technetium99m (Tc99m) colloid for the purpose of sentinel lymph node biopsy (SLNB) in early breast cancer is considered the gold standard in Germany. However, new tracers, such as near-infrared (NIR) imaging agents like indocyanine green (ICG) could offer an alternative in future, as they overcome drawbacks associated with radioactive Technetium99m (Tc99m) like limited availability, high costs and radioactivity exposure for both patients and surgeons. METHODS In this double-arm retrospective study, we sought to establish the usefulness of indocyanine green as an alternative or an addition to the conventional Technetium99m (Tc99m) in the identification of the SLN in early breast cancer. RESULTS Among the 161 patients who underwent primary SLNB, 34 patients had at least 1 SLN with metastasis. Among these patients with SLN metastasis, 33 had the SLN detected by ICG; while 31 had the SLN detected by Tc99m. The conventional Technetium99m radiotracer failed to detect 2 patients with metastasis in this Arm of the study. Among the 87 patients who underwent SLNB after NACT, 13 patients had at least 1 SLN with metastasis. Among these 13 patients with SLN metastasis, ICG and Tc99m had detected the SLN among 12 patients, while 1 patient had been detected by ICG alone. CONCLUSIONS Our results show that ICG is as effective as the radioisotope for SLNB even among patients who have undergone NACT. This trial is registered with the German Clinical Trial Register, ID: DRKS00013606.
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Affiliation(s)
- Petronilla Staubach
- Department of Obstetrics and Gynecology, St. Marien Hospital, Amberg, Germany.
| | - Anton Scharl
- Department of Obstetrics and Gynecology, St. Marien Hospital, Amberg, Germany
| | - Atanas Ignatov
- Department of Obstetrics and Gynecology, University Hospital Regensburg, Landshuter Str. 65, 93053, Regensburg, Germany
| | - Olaf Ortmann
- Department of Obstetrics and Gynecology, University Hospital Regensburg, Landshuter Str. 65, 93053, Regensburg, Germany
| | - Elisabeth C Inwald
- Department of Obstetrics and Gynecology, University Hospital Regensburg, Landshuter Str. 65, 93053, Regensburg, Germany
| | - Thomas Hildebrandt
- Department of Obstetrics and Gynecology, University Hospital Erlangen-Nuremberg, Maximilianspl. 2, 91054, Erlangen, Germany
| | - Michael Gerken
- Tumor Center of the University of Regensburg, Institute for Quality Assurance and Health Services Research, Regensburg, Germany
| | - Monika Klinkhammer-Schalke
- Tumor Center of the University of Regensburg, Institute for Quality Assurance and Health Services Research, Regensburg, Germany
| | - Sophia Scharl
- Department of Radiooncology and Radiotherapy, Technical University Hospital Munich, Ismaninger Str. 22, 81675, Munich, Germany
| | - Thomas Papathemelis
- Department of Obstetrics and Gynecology, St. Marien Hospital, Amberg, Germany
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Somashekhar SP, Kumar CR, Ashwin KR, Zaveri SS, Jampani A, Ramya Y, Parameswaran R, Rakshit S. Can Low-cost Indo Cyanine Green Florescence Technique for Sentinel Lymph Node Biopsy Replace Dual Dye (Radio-colloid and Blue Dye) Technique in Early Breast Cancer: A Prospective Two-arm Comparative Study. Clin Breast Cancer 2020; 20:e576-e583. [PMID: 32389561 DOI: 10.1016/j.clbc.2020.03.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 03/26/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND The objective of this study was to assess the detection and accuracy of sentinel lymph node (SLN) biopsy (SLNB) using the low-cost indocyanine green (ICG) fluorescence method and to compare this method with the gold standard dual-dye method (radio-colloid + methylene blue dye [MB]). MATERIALS AND METHODS One hundred patients with node-negative early breast cancer assessed clinically and by ultrasound axilla underwent an SLNB procedure using technetium-99m radio-colloid, MB, and ICG. The detection rate of SLNs and positive SLNs and the number of SLNs were compared. The injection safety of ICG and MB was evaluated. RESULTS One hundred female patients with a median age of 52.3 years participated in the study. Sixty-eight percent had a body mass index < 25, 85% presented with a palpable lump, of which 59% were in the outer quadrant. SLNs were identified in all 100 cases. A total of 290 SLNs were removed (mean, 2.9; range, 1-6). The identification rate with dual dye was 94%, whereas with ICG alone, it was 96%. The SLNB sensitivity rate and false negative rate were 97.6% versus 93.2% and 3.1% versus 6.2% in the ICG and dual-dye combination, respectively. None of the patients had any local or systemic reaction with ICG; 3 patients with blue dye had tattooing and staining of skin. CONCLUSION ICG fluorescence imaging permits real time visualization of lymphatics and provides an additional dimension to SLN biopsy that is safe and effective. These results confirm high sensitivity for fluorescence localization with comparable performance to the gold standard. ICG can reliably replace dual dye and be employed as a sole tracer for SLNB in early breast cancer.
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Affiliation(s)
- S P Somashekhar
- Department of Surgical Oncology, Manipal Comprehensive Cancer Centre, Manipal Hospital, Bangalore, India.
| | - C Rohit Kumar
- Department of Surgical Oncology, Manipal Comprehensive Cancer Centre, Manipal Hospital, Bangalore, India
| | - K R Ashwin
- Department of Surgical Oncology, Manipal Comprehensive Cancer Centre, Manipal Hospital, Bangalore, India
| | - Shabber S Zaveri
- Department of Surgical Oncology, Manipal Comprehensive Cancer Centre, Manipal Hospital, Bangalore, India
| | - Anil Jampani
- Department of Surgical Oncology, Manipal Comprehensive Cancer Centre, Manipal Hospital, Bangalore, India
| | - Y Ramya
- Department of Surgical Oncology, Manipal Comprehensive Cancer Centre, Manipal Hospital, Bangalore, India
| | - Rameshwaran Parameswaran
- Department of Nuclear Medicine, Manipal Comprehensive Cancer Centre, Manipal Hospital, Bangalore, India
| | - Sushmita Rakshit
- Department of Pathology, Manipal Comprehensive Cancer Centre, Manipal Hospital, Bangalore, India
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19
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Goonawardena J, Yong C, Law M. Use of indocyanine green fluorescence compared to radioisotope for sentinel lymph node biopsy in early-stage breast cancer: systematic review and meta-analysis. Am J Surg 2020; 220:665-676. [PMID: 32115177 DOI: 10.1016/j.amjsurg.2020.02.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 01/12/2020] [Accepted: 02/03/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND In early-stage breast cancer, indocyanine green (ICG)-fluorescence based sentinel lymph node (SLN) detection is being considered. This is a meta-analysis of SLN detection rates and sensitivity of ICG-fluorescence compared to radioisotope (RI), to evaluate its clinical applicability. DATA SOURCES Systematic review of full-text articles from PubMed and Scopus, of women with early breast cancer who underwent SLN mapping using ICG and RI concurrently was performed. The meta-analysis was performed using the Mantel-Haenszel method. RESULTS 2301 patients from 19 studies were included. No significant difference was observed between ICG and RI for SLN detection (OR0.90,95%CI0.66-1.24) or sensitivity (OR1.23,95%CI0.73-2.05) with heterogeneity between studies (I2 = 58%,P = 0.003). Sensitivity of dual mapping (ICG + RI) was significantly better compared to single mapping with RI (OR3.69,95%CI1.79-7.62) or ICG (OR3.32,95%CI1.52-7.24) alone with no heterogeneity between studies (I2 = 0%,P = 0.004). CONCLUSION ICG-fluorescence could complement RI method or provide alternative in centers with poor accessibility to RI lymphoscintigraphy.
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Affiliation(s)
- Janindu Goonawardena
- Breast and Endocrine Surgery, Eastern Health, Box Hill, Victoria, 3128, Australia.
| | - Charles Yong
- Breast and Endocrine Surgery, Eastern Health, Box Hill, Victoria, 3128, Australia
| | - Michael Law
- Breast and Endocrine Surgery, Eastern Health, Box Hill, Victoria, 3128, Australia
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20
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Hamdy O, El-Badrawy A, Saleh GA, Metwally IH, Abdelwahab K, Farouk O, Denewer A, Setit A. Preoperative localization of sentinel lymph node in breast cancer patients by silver wire insertion or liquid charcoal injection guided by CT lymphography. Breast J 2019; 26:617-624. [PMID: 31448502 DOI: 10.1111/tbj.13511] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 07/14/2019] [Accepted: 07/16/2019] [Indexed: 12/23/2022]
Abstract
Dual localization of SLN in breast cancer patients using isotope & dye is the best-approved modality with limitations such as high cost of radioactive materials, complex logistic preparations & scheduling issues, especially in developing countries. We investigated the feasibility & accuracy of a novel technique for SLN localization using silver wire insertion or liquid charcoal injection guided by CT lymphography. 120 patients with clinically node-negative breast cancer were enrolled. In the test group, SLN was localized using preoperative CTLG guided injection of liquid charcoal or by placing a 3 cm silver wire. In addition, intraoperative SLN mapping was performed using methylene blue dye followed by searching for the SLN localized by both methods. In the control group, SLN was localized by the blue dye only. Feasibility, accuracy, detection rates, and number of SLNs retrieved were reported as well as matching between the LN detected with the CTLG and that detected with the dye technique. SLN could be detected in 59 out of 60 patients (98.3%) in the test group and in 54 out of 60 patients (90%) in the control group (P = .057). In self-controlled analysis of the test group comparing CTLG only to dye only was significant (P = .050). Comparing charcoal to silver wire in detection was statistically insignificant (P = .5). This novel method can offer advantages which are as follows: being more accurate than the dye alone, saving operative time, abandoning complex logistic preparations for the radioisotope, and solving the problem of timing.
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Affiliation(s)
- Omar Hamdy
- Surgical Oncology Unit, Oncology Center, Mansoura University, Mansoura, Egypt
| | - Adel El-Badrawy
- Radiology Department, Faculty of medicine, Mansoura University, Mansoura, Egypt
| | - Gehad A Saleh
- Radiology Department, Faculty of medicine, Mansoura University, Mansoura, Egypt
| | - Islam H Metwally
- Surgical Oncology Unit, Oncology Center, Mansoura University, Mansoura, Egypt
| | - Khaled Abdelwahab
- Surgical Oncology Unit, Oncology Center, Mansoura University, Mansoura, Egypt
| | - Omar Farouk
- Surgical Oncology Unit, Oncology Center, Mansoura University, Mansoura, Egypt
| | - Adel Denewer
- Surgical Oncology Unit, Oncology Center, Mansoura University, Mansoura, Egypt
| | - Ahmed Setit
- Surgical Oncology Unit, Oncology Center, Mansoura University, Mansoura, Egypt
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Hameed S, Chen H, Irfan M, Bajwa SZ, Khan WS, Baig SM, Dai Z. Fluorescence Guided Sentinel Lymph Node Mapping: From Current Molecular Probes to Future Multimodal Nanoprobes. Bioconjug Chem 2018; 30:13-28. [DOI: 10.1021/acs.bioconjchem.8b00812] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Sadaf Hameed
- Department of Biomedical Engineering, College of Engineering, Peking University, Beijing 100871, China
| | - Hong Chen
- Department of Biomedical Engineering, College of Engineering, Peking University, Beijing 100871, China
| | - Muhammad Irfan
- Department of Medicines, Gujranwala Medical College, Gujranwala 52250, Pakistan
| | - Sadia Zafar Bajwa
- National Institute of Biotechnology and Genetic Engineering, Faisalabad 38000, Pakistan
| | - Waheed S Khan
- National Institute of Biotechnology and Genetic Engineering, Faisalabad 38000, Pakistan
| | - Shahid Mahmood Baig
- National Institute of Biotechnology and Genetic Engineering, Faisalabad 38000, Pakistan
| | - Zhifei Dai
- Department of Biomedical Engineering, College of Engineering, Peking University, Beijing 100871, China
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