Title: Fluorescence Imaging Combined with Ultrasound in SLN Biopsy of Breast Cancer
Abstract: To evaluate the accuracy of preoperative locating sentinel lymph node(SLN) of breast cancer by indocyanine green (ICG) fluorescence imaging combined with ultrasound, and the feasibility of ultrasound-guided core needle biopsy (CNB) of SLN replacing SLNB. A total of 89 early breast cancers with negative axillary lymph nodes(by clinical physical and imaging) were preoperative located SLNs by ICG fluorescence imaging combined with ultrasound during Apr 2015 and Jun 2017. The SLNs were underwent ultrasound-guided CNB and marked with breast cancer tissue marker. During the operation, SLNB was performed by blue dye tracer. 1.The preoperative detection rate of SLN was 100% (89/89) by ICG fluorescence imaging combined with ultrasound. 2. The consistency of preoperative marked SLN and SLN detected in the surgical procedure was 97.8% (87/89). 3.There were 4 metastasis by HE stain and 6 metastasis by CK stain in CNB. Frozen and paraffin pathology showed 15 and 17 cases with metastasis respectively, including 9 cases with micrometastasis in SLNB. The consistency between preoperative CNB of SLN and postoperative pathologic is poor after Kappa consistency test. 1. ICG fluorescence imaging combined with ultrasound could accurately preoperative determine and locate SLNs with high detected rate. 2. The preoperative marked SLN by ICG fluorescence imaging combined with ultrasound is highly consistent with that by blue dye tracer. 3. This technology may help sonographers to locate the area of SLN rapidly and observe the SLNs carefully. 4. Preoperative diagnosis accuracy of SLN by CNB is slightly worse than that by blue dye. CK stain contributes to finding metastasis in lymph nodes.