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Transcutaneous detection and direct approach to the sentinel node using axillary compression technique in ICG fluorescence-navigated sentinel node biopsy for breast cancer.
MedLine Citation:
PMID:  21725656     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Indocyanine green (ICG) fluorescence navigation is a useful option in sentinel node biopsy (SNB) for breast cancer. However, several technical difficulties still exist. Since the sentinel node (SN) cannot be recognized over the skin, subcutaneous lymphatic vessels (LVs) must be carefully dissected without injury. In addition, the dissecting procedures are often interrupted by turning off the operating light during fluorescence observation. In this report, we introduce a new approach using the axillary compression technique to overcome these problems. MATERIALS AND METHODS: In the original procedure of the ICG fluorescence method, the subcutaneous lymphatic drainage pathway from the breast to the axilla was observed in fluorescence images, but no signal could be obtained in the axilla. When the axillary skin was compressed against the chest wall using a plastic device, the signals from the deeper lymphatic structures could be observed. By tracing the compression-inducible fluorescence signal towards the axilla, transcutaneous detection and direct approach to the SN were achieved. The benefit of this approach is that there is no risk of injury of LVs, and the procedures are interrupted less frequently by fluorescence observation. The axillary compression technique was used in 50 patients with early breast cancer. RESULTS: SNs were successfully removed in all patients. Transcutaneous detection and direct approach were possible in 47 patients. This approach was also effective in obese patients. CONCLUSIONS: Axillary compression technique is a simple way to facilitate the surgical procedures of ICG fluorescence-navigated SNB for breast cancer.
Authors:
Toshiyuki Kitai; Masahiro Kawashima
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-2
Journal Detail:
Title:  Breast cancer (Tokyo, Japan)     Volume:  -     ISSN:  1880-4233     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-7-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888201     Medline TA:  Breast Cancer     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Surgery, Nara Social Insurance Hospital, Yamatokoriyama, Japan, kitait@kuhp.kyoto-u.ac.jp.
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