Patients suffering from breast cancer may experience Fluorescence Guided Surgery with Verdye Indocyanine Green at two different times. Sometimes during a single operation. Since ICG-fluorescence may be used as a safe and effective alternative to the gold standard for Sentinel Lymph Node Biopsy, which is radioguided surgery with radioisotope technetium-labeled (99mTc)-nanocolloid in patients with early-stage breast cancer1. It could reduce the use of ionizing radiation and blue dye, introduce lower costs and solve logistical problems.
If breast reconstruction is considered after mastectomy or skin or nipple-sparing surgery, there is increasing evidence available to recommend using ICG for dynamic perfusion imaging for reducing the risk of skin-, fat necrosis or implant loss. This will reduce complication rates, lowers morbidity, shortens hospital stays and produces for the patient a better overall result.
1Bargon CA, Huibers A, Young-Afat DA, et al. Sentinel Lymph Node Mapping in Breast Cancer Patients Through Fluorescent Imaging Using Indocyanine Green, The INFLUENCE Trial. Ann Surg 2022;276:913–920
2Da Silva Neto E, Figueiredo PHM, Moro MG, et al. Use of laser assisted indocyanine green angiography in breast reconstruction: systemic review and meta-analysis, Journal of Surgical Oncology, Nov 2019, DOI:10.1002/jso.25782
3Bigdeli AK, Thomas B, Falkner F, Gazyakan E, Hirche C, Kneser U. The Impact of Indocyanine-Green Fluorescence Angiography on Intraoperative Decision-Making and Postoperative Outcome in Free Flap Surgery. J Reconstr Microsurg. 2020 Oct;36(8):556-566. doi: 10.1055/s-0040-1710552. Epub 2020 May 14. PMID: 32408364.
4Hembd AS, Yan J, Zhu H, Haddock NT, Teotia SS. Intraoperative Assessment of DIEP Flap Breast Reconstruction Using ICG Angiography: Reduction of Fat Necrosis, Resection Volumes and Post-operative Surveillance. Plast Reconstr Surg. 2020 Apr 13. doi: 10.1097/PRS.0000000000006888. Epub ahead of print. PMID: 32301911
