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This study aimed to assess the efficacy of the combination of indocyanine green (ICG) and methylene blue (MB) dye in early breast cancer patients undergoing sentinel lymph node biopsy (SLNB). Between January 2011 and December 2015, 1061 early breast cancer patients underwent SLNB were included. SLNB was performed for enrolled patients by injection of both ICG and MB. Detection rate, positivity, and number of sentinel lymph nodes (SLNs) by ICG and MB were analysed. Axillary recurrence and arm lymphedema at 5.6-year follow-up were reported. The combination of ICG and MB resulted in a very high detection rate of 99.6%, the median number of sentinel lymph nodes was 3. A total of 374 histologically confirmed positive SLNs were detected in 237 patients, 96.6% of the positive patients and 94.1% of the positive nodes could be identified by the combination of ICG and MB. After a median follow-up of 5.6 (2-9.3) years, 0.64% of patients with negative SLNs had ipsilateral axillary recurrence, and the incidence of arm lymphedema was 2.1%. Although the missing isotope control weakens the interpretation of the findings, the dual tracing modality of ICG and MB, without involvement of radioactive isotopes, was an effective method for SLNB in patients with early breast cancer. ACTRN12612000109808. Registered on 23 January 2012.


Chaobin Wang, Fuzhong Tong, Yingming Cao, Peng Liu, Bo Zhou, Hongjun Liu, Lin Cheng, Miao Liu, Jiajia Guo, Fei Xie, Houpu Yang, Siyuan Wang, Yuan Peng, Shu Wang. Long-term follow-up results of fluorescence and blue dye guided sentinel lymph node biopsy in early breast cancer. Breast cancer research and treatment. 2021 Mar 24

PMID: 33761081

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