Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care Poster Display session

261P - The application of indocyanine green fluorescence navigation method to a sentinel lymph node biopsy after neoadjuvant chemotherapy in node-positive breast cancer

Presentation Number
261P
Lecture Time
12:45 - 12:45
Speakers
  • Kazuhiko Yamagami (Kobe, JP)
Location
Hall A3 - Poster Area Networking Hub, ICM M√ľnchen, Munich, Germany
Date
22.10.2018
Time
12:45 - 13:45

Abstract

Background

Approximately 40% of patients with node positive in axilla (N1) will have axillary pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC). The application of sentinel lymph nodes (SNs) biopsy (SNB) following NAC for initially node-positive breast cancer is unclear because of high false-negative results in previous studies (SENTINA, ACOSOG Z1071). These trials, using blue dye (BD) and/or radioisotope (RI) agent, showed the diagnostic accuracy of SNB was closely related to the number of SNs. We presented the efficacy of indocyanine green (ICG) fluorescence navigation method for SNB in clinically node-negative (cN0) patients (ASCO2008). The fluorescent ICG method can provide higher number of SNs. Moreover, some reports showed that florescence SNs with metastases could not be identified by radioactivity. To determine the detection rate, the false-negative rate of SNs using the fluorescent ICG method after NAC for biopsy-proved N1 breast cancer retrospectively.

Methods

Of 2301 patients (January 2010 - March 2018), 135 women with N1 (fine needle aspiration or core needle biopsy proved) received NAC. Node status after NAC was evaluated by ultrasound findings: Group 1 (N1 converted ycN0, n = 105) and Group 2 (N1 remained ycN1, n = 30). All patients underwent SNB using both ICG- and BD-method and axillary lymph node dissection.

Results

The average number of SNs removed were Group 1 (ICG: 3.65, BD: 1.37), Group 2 (ICG: 2.99, BD: 0.93). Detection rate of SNs: Group 1 ICG 97.1% (95% CI 91.9-99.0, 102 of 105), BD 77.1% (95% CI 68.2-84.1, 81 of 105), Group 2 ICG 86.7% (95% CI 70.3-94.7, 26 of 30), BD 53.3% (95% CI 36.1-69.8, 16 of 30). Resulting of a false-negative rate: Group 1 ICG 7.69% (95% CI 2.65-20.3, 3 of 39), BD 35.7% (95% CI 20.7-54.2, 10 of 28), Group 2 ICG 11.5% (95% CI 4.00-29.0, 3 of 26), BD 18.8% (95% CI 6.59-43.0, 3 of 16). Axillary pCR was 46.7% (63 of 135).

Conclusions

In patients whose axillary nodal status converted from N1 to ycN0, the fluorescent ICG method with higher number detection of SNs showed a remarkable high detection rate and a low false-negative rate of SNs, compared with those of Blue dye which is one of conventional method.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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