Systematic review of the usefulness of indocyanine green in identification of the sentinel lymph node in stage I and II breast cancer.

Abstract

Introduction: Indocyanine green is a hydrophilic, fluorescent and low-toxic substance developed in 1956. Its chemical and fluorescent characteristics have made it an ideal tracer in sentinel lymph node mapping in oncological surgery. This article is a systematic review on the usefulness of indocyanine green in identification of the sentinel lymph node in stage I and II breast cancer. Methods: A systematic search was carried out in the search engine database, Pubmed, Google Scholar, Cochrane and Scielo. Only analytical and prospective observational studies were analyzed, published between January 1, 2020 and December 15, 2022. The Medical Subject Heading (MESH) terms used combined with Boolean search engines: “Indocyanine green” AND “sentinel lymph node” AND “breast cancer” OR “indocyanine green”. Results: 37 studies were identified in Pubmed, 31 by Google Scholar, 20 in the Cochrane library and no results were obtained in the Scielo search engine. Of the 88 studies, 55 were excluded based on their titles, study designs, and lack of availability in the English language. Of the remaining 33 studies that warranted full reading, 27 were excluded. 6 studies were considered, with a total of 815 patients. Conclusion: Indocyanine green is useful in identifying the sentinel lymph node in stage I and II breast cancer, as a safe, fast and effective.