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Indocyanine Green Fluorescence Axillary Reverse Mapping for Sentinel Node Navigation Surgery in Breast Cancer

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ICG Fluorescence Imaging and Navigation Surgery
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Introduction: We investigated whether indocyanine green (ICG) fluorescence axillary reverse mapping (ICG-ARM) is beneficial for evaluating the risk of lymphedema.

Patients and Methods: Between August 2009 and November 2013, 455 patients were enrolled in this study. Using a fluorescence camera, we checked the ICG accumulation of sentinel nodes and divided into corresponding group and non-corresponding group. Rate of concordance between ARM lymphatics and localization of SN was also investigated.

Results: Among the 455 axillary sites, 105 cases (23.1 %) were included in the corresponding group. Lymphedema developed in 6 of the 455 cases (1.3 %) in the overall population and in 6 of 105 cases (5.7 %) in the corresponding group, and no patient from the non-corresponding group developed lymphedema. In the upper side of the second intercostobrachial nerve (2ICBN), concordance rate of UE lymphatics and breast SN was 47/101 (46.5 %) and around the 2ICBN was 117/277 (42.2 %). On the other hand, only one patient observed UE lymphatics in the caudal side of 2ICBN.

Conclusion: ICG-ARM for sentinel node navigation surgery is useful for the selection of patients who are at risk for lymphedema.

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Correspondence to Takashi Sakurai M.D. .

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Sakurai, T. (2016). Indocyanine Green Fluorescence Axillary Reverse Mapping for Sentinel Node Navigation Surgery in Breast Cancer. In: Kusano, M., Kokudo, N., Toi, M., Kaibori, M. (eds) ICG Fluorescence Imaging and Navigation Surgery. Springer, Tokyo.

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