One-year postoperative morbidity associated with near-infrared-guided indocyanine green (ICG) or ICG in conjugation with human serum albumin (ICG:HSA) sentinel lymph node biopsy.
BACKGROUND
Sentinel lymph node biopsy (SLNB) is a standard staging procedure in breast cancer and skin melanoma patients. Radioactive colloid (RC) and blue dye are the routinely used markers for staining. The new dye used in this procedure, indocyanine green (ICG), seems to have true potential in near-infrared-guided SLNB. The aim of this study was to analyze 1-year morbidity after SLNB using RC and ICG or RC and ICG conjugated to human serum albumin (ICG:HSA) in breast cancer and skin melanoma patients.


METHODS
Forty-nine patients diagnosed with breast cancer and 10 patients with skin melanoma underwent SLNB using ICG with RC and ICG:HSA with RC. A total of 47 SLNB patients without the need for additional lymphadenectomy were evaluated approximately 1 year (11-13 months) for the presence of tattoo, extremity swelling, nerve dysfunction/pain, range of motion, and stiffness.


RESULTS
From the 47 patients examined, long-term morbidity was present in 3 (6.4%). In 1 patient, tattoo persisted for 11 months. Mild lymphedema was seen in 1 patient, and 1 patient exhibited minor functional deficit.


CONCLUSIONS
Using ICG or ICG:HSA seems to be safe, and long-term morbidity in SLNB patients is low. However, skin discoloration may appear as it does after the use of blue dye, and an increased number of harvested nodes might be associated with an increased number of iatrogenic lymphedema.
Wielkopolska Cancer Centre, Poznan, Poland dmurawa@gmail.com.
Dawid
D
Murawa
Wielkopolska Cancer Centre, Poznan, Poland.
Karol
K
Polom
Wielkopolska Cancer Centre, Poznan, Poland Poznan University of Medical Sciences, Poznan, Poland.
Pawel
P
Murawa
D001943:Breast Neoplasms / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007208:Indocyanine Green / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology; D021701:Sentinel Lymph Node Biopsy / Q000009:adverse effects* / Q000379:methods*; D012709:Serum Albumin; D012867:Skin / Q000473:pathology; D019265:Spectroscopy, Near-Infrared / Q000379:methods*
D012709:Serum Albumin; D007208:Indocyanine Green
breast cancer; complications; indocyanine green; melanoma; morbidity; sentinel lymph node biopsy