The indocyanine green method is equivalent to the 99mTc-labeled radiotracer method for identifying the sentinel node in breast cancer: A concordance and validation study

We assessed concordance between the indocyanine green (ICG) method and 99mTc-radiotracer method to identify the sentinel node (SN). One hundred thirty-four women with clinically node-negative early breast cancer received preoperative injection of 99mTc-labeled tracer for lymphoscintigraphy, followed by intraoperative injection of ICG for detection of SNs. The 134 patients provided 246 SNs, detected by one or both methods. The two methods were concordant for 230/246 (93.5 %) SNs and discordant for 16 (6.5 %) SNs. The ICG method detected 99.6 % of all SNs. Fluorescent lymphangiography with ICG allows an easy identification of axillary SNs, at a frequency not inferior to that of the radiotracer method and can be used alone to reliably identify SNs.