Sentinel lymph node biopsy (SLNB) has become the standard of care for clinically node-negative breast cancer and has recently been shown by clinical trials to be also feasible for clinically node-positive patients treated with primary systemic therapy. The dual technique using both radioisotope (RI) and blue dye (BD) as tracers for the identification of sentinel lymph nodes is considered the gold standard. However, allergic reactions to blue dye as well as logistics issues related to the use of radioactive agents, have led to research on new sentinel lymph node (SLN) tracers and to the development and introduction of novel techniques in the clinical practice. Indocyanine green (ICG) is a water-soluble dye with fluorescent properties in the near-infrared (NIR) spectrum. ICG has been shown to be safe and effective as a tracer during SLNB for breast cancer and accumulating evidence suggests that ICG is superior to BD and at least comparable to RI alone and to RI combined with BD. Thus, ICG was recently proposed as a reliable SLN tracer in some breast cancer clinical practice guidelines. Nevertheless, there is lack of consensus regarding the optimal role of ICG for SLN mapping. Specifically, it is yet to be determined whether ICG should be used in addition to BD and/or RI, or if ICG could potentially replace these long-established traditional SLN tracers. This article is an updated overview of somerecent studies that compared ICG with BD and/or RI regarding their accuracy and effectiveness during SLNB for breast cancer.
前哨淋巴结活检（SLNB）已成为临床淋巴结阴性乳腺癌的标准诊疗方法，近期临床试验亦证实其在接受新辅助系统治疗的临床淋巴结阳性患者中同样可行。联合使用放射性同位素（RI）与蓝染料（BD）的双示踪技术被视为前哨淋巴结识别的金标准。然而，蓝染料引发的过敏反应及放射性药物使用相关的操作难题，促使学界探索新型前哨淋巴结（SLN）示踪剂，并推动创新技术进入临床实践。吲哚菁绿（ICG）是一种具有近红外（NIR）光谱荧光特性的水溶性染料。研究证实ICG在乳腺癌SLNB中作为示踪剂安全有效，且累积证据表明其性能优于BD，至少与单用RI或RI联合BD相当。因此，部分乳腺癌临床实践指南已将ICG列为可靠的前哨淋巴结示踪剂。然而，关于ICG在前哨淋巴结定位中的最佳作用尚未形成共识，特别是ICG应作为BD和/或RI的补充示踪剂，抑或可能替代这些传统示踪剂，仍有待明确。本文通过综述近期比较ICG与BD和/或RI在乳腺癌SLNB中准确性及有效性的研究，对此进行更新探讨。
肿瘤(癌症)患者之家