Diagnostic Performance of Indocyanine Green-Guided Sentinel Lymph Node Biopsy in Breast Cancer: A Meta-Analysis.
BACKGROUND
The diagnostic performance of indocyanine green (ICG) fluorescence-guided sentinel lymph node biopsy (SLNB) for the presence of metastases in breast cancer remains unclear.


OBJECTIVE
We performed a meta-analysis to investigate the diagnostic performance of ICG-guided SLNB.


METHODS
Eligible studies were identified from searches of the databases PubMed and EMBASE up to September 2015. Studies that reported the detection rate of ICG fluorescence-guided SLNB with full axillary lymph node dissection and histological or immunohistochemical examinations were included. A meta-analysis was performed to generate pooled detection rate, sensitivity, specificity, false negative rate, diagnostic odds ratio (DOR) and a summary receiver operator characteristic curve (SROC).


RESULTS
Nineteen published studies were included to generate a pooled detection rate, comprising 2594 patients. The pooled detection rate was 0.98 (95% confidence interval [CI], 0.96-0.99). Six studies finally met the criteria for meta-analysis, which yielded a pooled sensitivity of 0.92 (95% CI, 0.85-0.96), specificity 1 (95% CI, 0.97-1), and DOR 311.47 (95% CI, 84.11-1153.39). The area under the SROC was 0.9758. No publication bias was found.


CONCLUSIONS
ICG fluorescence-guided SLNB is viable for detection of lymph node metastases in breast cancer. Large-scale randomized multi-center trials are necessary to confirm our results.
Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
Xiaohui
X
Zhang
Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
Yan
Y
Li
Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
Yidong
Y
Zhou
Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
Feng
F
Mao
Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
Yan
Y
Lin
Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
Jinghong
J
Guan
Department of Breast Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
Qiang
Q
Sun
D001943:Breast Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000601:surgery; D004396:Coloring Agents / Q000378:metabolism; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D007208:Indocyanine Green / Q000378:metabolism*; D000071036:Sentinel Lymph Node / Q000601:surgery*; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*
D004396:Coloring Agents; D007208:Indocyanine Green