Indocyanine green for sentinel lymph node detection in early breast cancer: Prospective evaluation of detection rate and toxicity-The FLUOBREAST trial.


Journal

The breast journal
ISSN: 1524-4741
Titre abrégé: Breast J
Pays: United States
ID NLM: 9505539

Informations de publication

Date de publication:
12 2020
Historique:
received: 25 05 2020
revised: 05 10 2020
accepted: 05 10 2020
pubmed: 24 10 2020
medline: 22 6 2021
entrez: 23 10 2020
Statut: ppublish

Résumé

Detection of sentinel lymph node in early breast cancer is commonly based on the combination of patent blue dye and a radioisotope 99m Technetium. Each of these two tracers has advantages and disadvantages leading to the development of the use of indocyanine green. We conducted a prospective clinical trial to compare the detection rate of indocyanine green with 99mTe. Each patient undergoing a sentinel lymph node biopsy for an early breast cancer received both indocyanine green and radioisotopes. The trial was registered: FLUOBREAST EudraCT N 2015-000698-11, ClinicalTrials.gov: NCT02875626. Among a total of 88 patients, 77 were assessable for a total of 205 nodes. Detection rates were 93% for the isotope and 96% for the indocyanine green. The combined detection rate was 99%. The overall concordance rate per patient was 91%. The median number of excised sentinel nodes was 2.3 for each tracer and 2.7 for the combined method (P = .21). All the macrometastatic nodes were detected by both indocyanine green and radioisotopes. The median time between incision of the axilla and removal of the last node was 14 minutes. There was neither allergy nor radio-sensitization linked with the use of indocyanine green. Indocyanine green delivers a high detection rate and sensitivity for the sentinel lymph node biopsy in early breast cancer, with short operative time and a normal number of excised sentinel lymph nodes. Allergy is extremely rare and there is no toxicity. Indocyanine green could be an alternative to radioisotopes to provide an accurate staging of the axilla. Its routine use should be approved.

Identifiants

pubmed: 33094498
doi: 10.1111/tbj.14100
doi:

Substances chimiques

Coloring Agents 0
Indocyanine Green IX6J1063HV

Banques de données

ClinicalTrials.gov
['NCT02875626']

Types de publication

Clinical Trial Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2357-2363

Subventions

Organisme : Fondation de l'Avenir pour la Recherche Médicale Appliquée
ID : AP-MAS-15-001
Organisme : Fondation de l'Avenir
ID : AP-MAS-15-001

Informations de copyright

© 2020 Wiley Periodicals LLC.

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Auteurs

Charlotte Ngô (C)

Hôpital Privé des Peupliers, Ramsay Santé, Paris, France.

Shervine Sharifzadehgan (S)

Service de chirurgie cancérologique gynécologique et du sein, Hôpital Européen Georges Pompidou, AP-HP, Paris, France.

Cynthia Lecurieux-Lafayette (C)

Service de chirurgie cancérologique gynécologique et du sein, Hôpital Européen Georges Pompidou, AP-HP, Paris, France.

Houda Belhouari (H)

ARTIC Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie, Paris, France.

Dominique Rousseau (D)

Département de pharmacie, Hôpital Européen Georges Pompidou, AP-HP, Paris, France.

Hélène Bonsang-Kitzis (H)

Hôpital Privé des Peupliers, Ramsay Santé, Paris, France.

Laurence Crouillebois (L)

ARTIC Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie, Paris, France.

Vincent Balaya (V)

Service de Gynécologie-obstétrique et chirurgie gynécologique et mammaire, Centre hospitalier Universitaire Vaudois, Lausanne, Switzerland.

Stéphane Oudard (S)

ARTIC Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie, Paris, France.
Faculty of Medicine, Paris Descartes University, Paris, France.
Service d'oncologie médicale, Hôpital Européen Georges Pompidou, AP-HP, Paris, France.

Fabrice Lécuru (F)

Faculty of Medicine, Paris Descartes University, Paris, France.
Département de chirurgie oncologique, Institut Curie, Paris, France.

Reza-Thierry Elaidi (RT)

ARTIC Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie, Paris, France.

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