The Journal of Practical Medicine ›› 2023, Vol. 39 ›› Issue (11): 1444-1450.doi: 10.3969/j.issn.1006⁃5725.2023.11.021

• Medical Examination and Clinical Diagnosis • Previous Articles     Next Articles

Application of indocyanine green near ⁃ infrared fluorescence imaging in breast conserving surgery for breast cancer 

JIAO Wei,ZHAO Kai,WANG Zheng,CHEN Bin,WANG Yabing.   

  1. Department of Thyroid and Breast Surgery,Yijishan Hospital,Wannan Medical College,Wuhu 241000,China 
  • Online:2023-06-10 Published:2023-06-10
  • Contact: WANG Yabing E⁃mail:wangeb3@wnmc.edu.cn,CHEN Bin E⁃mail:chenbin@yjsyy.com

Abstract:

Objective To assess the value of near⁃infrared fluorescence imaging combined with indocyanine green contrast agents in breast ⁃ conserving surgery for breast cancer. Methods The clinical data on 155 patients with breast cancer who had received surgical treatment in Yijishan Hospital of Wannan Medical College from January 2020 to April 2022 were analyzed. Of those patients,55 were labeled with indocyanine green and underwent surgery under the guidance of anear⁃infrared fluorescence imaging system(fluorescence group)and 100 receivedconventional breast conserving surgery(control group). The clinical characteristics,diagnostic rate,and margin status were com⁃ pared between the two groups,and the role of near⁃infrared fluorescence imaging in intraoperative tumor localization and margin determination was explored. Results The mean resection time was(13.85 ± 3.39)min in the fluores⁃ cence group,which was faster than(18.78 ± 4.81)min in the control group(P < 0.05). The positive rate of first inci⁃ sion margin was significantly lower in the fluorescence group than in thecontrol group(3.6%vs. 19.0%,P < 0.05). Fluorescence was detectablein primary tumors in all thepatients. The average fluorescence intensity was(229.84 ± 22.03),(144.02 ± 14.12)and(108.64 ± 9.76)arbitrary units(AU)in tumor,peritumoral and normal tissues(P < 0.05). The background ratio of tumor fluorescence signal to peritumoral tissue and tonormal tissue was(1.60 ± 0.17) and(2.13 ± 0.25),respectively(P < 0.05). The sensitivity and specificity of near⁃infrared fluorescence imaging forassessing the incisionmargin were 86.66% and 94.23%,respectively. Conclusions Intraoperative application of near⁃infrared fluorescence imaging for tumor localization can effectively avoid excessive resection of normal tissues. It has high sensitivity and specificity for the evaluation of cutting edge statusand can significantly reduce the positive.rate of cutting edge and shorten the surgical duration. Near⁃infrared fluorescence imaging technology is safe and feasible in breast⁃conserving surgery for breast cancer and has important guiding value. 

Key words: near?infrared fluorescence, breast cancer, indocyanine green, surgical margin