Janindu Goonawardena1, Charles Yong2, Michael Law2. 1. Breast and Endocrine Surgery, Eastern Health, Box Hill, Victoria, 3128, Australia. Electronic address: janindu.pg@gmail.com. 2. Breast and Endocrine Surgery, Eastern Health, Box Hill, Victoria, 3128, Australia.
Abstract
BACKGROUND: In early-stage breast cancer, indocyanine green (ICG)-fluorescence based sentinel lymph node (SLN) detection is being considered. This is a meta-analysis of SLN detection rates and sensitivity of ICG-fluorescence compared to radioisotope (RI), to evaluate its clinical applicability. DATA SOURCES: Systematic review of full-text articles from PubMed and Scopus, of women with early breast cancer who underwent SLN mapping using ICG and RI concurrently was performed. The meta-analysis was performed using the Mantel-Haenszel method. RESULTS: 2301 patients from 19 studies were included. No significant difference was observed between ICG and RI for SLN detection (OR0.90,95%CI0.66-1.24) or sensitivity (OR1.23,95%CI0.73-2.05) with heterogeneity between studies (I2 = 58%,P = 0.003). Sensitivity of dual mapping (ICG + RI) was significantly better compared to single mapping with RI (OR3.69,95%CI1.79-7.62) or ICG (OR3.32,95%CI1.52-7.24) alone with no heterogeneity between studies (I2 = 0%,P = 0.004). CONCLUSION: ICG-fluorescence could complement RI method or provide alternative in centers with poor accessibility to RI lymphoscintigraphy.
BACKGROUND: In early-stage breast cancer, indocyanine green (ICG)-fluorescence based sentinel lymph node (SLN) detection is being considered. This is a meta-analysis of SLN detection rates and sensitivity of ICG-fluorescence compared to radioisotope (RI), to evaluate its clinical applicability. DATA SOURCES: Systematic review of full-text articles from PubMed and Scopus, of women with early breast cancer who underwent SLN mapping using ICG and RI concurrently was performed. The meta-analysis was performed using the Mantel-Haenszel method. RESULTS: 2301 patients from 19 studies were included. No significant difference was observed between ICG and RI for SLN detection (OR0.90,95%CI0.66-1.24) or sensitivity (OR1.23,95%CI0.73-2.05) with heterogeneity between studies (I2 = 58%,P = 0.003). Sensitivity of dual mapping (ICG + RI) was significantly better compared to single mapping with RI (OR3.69,95%CI1.79-7.62) or ICG (OR3.32,95%CI1.52-7.24) alone with no heterogeneity between studies (I2 = 0%,P = 0.004). CONCLUSION:ICG-fluorescence could complement RI method or provide alternative in centers with poor accessibility to RI lymphoscintigraphy.
Authors: Zoltán Mátrai; Péter Kelemen; Csaba Kósa; Róbert Maráz; Attila Paszt; Gábor Pavlovics; Ákos Sávolt; Zsolt Simonka; Dezső Tóth; Miklós Kásler; Andrey Kaprin; Petr Krivorotko; Ferenc Vicko; Piotr Pluta; Agnieszka Kolacinska-Wow; Dawid Murawa; Jerzy Jankau; Slawomir Ciesla; Daniel Dyttert; Martin Sabol; Andrii Zhygulin; Artur Avetisyan; Alexander Bessonov; György Lázár Journal: Pathol Oncol Res Date: 2022-06-15 Impact factor: 2.874