No abstract

Although a number of factors have been correlated with seroma formation, strong evidence is still scarce. However, there is evidence showing that sentinel lymph node biopsy reduces seroma formation.

There is considerable variability in the way seroma is defined across studies, and its pathophysiology remains uncertain.

Purpose. This study compared the clinical utility of indocyanine green (ICG) fluorescence and radioisotope (RI) for sentinel lymph node (SLN) detection in breast cancer. Methods. Women with node-negative breast cancer underwent SLN biopsy using ICG fluorescence and RI. The primary end point was the sensitivity of ICG fluorescence compared with RI in the patients with tumor-positive SLNs. Secondary end points included detection rates for SLN, the additive effect of ICG fluorescence to RI, signature of positive SLNs according to tier, and adverse events related to ICG administration. Results. A total of 847 women with clinical node-negative breast cancer underwent SLN biopsy, and 821 patients were included in the per-protocol analysis. SLN mapping was performed using ICG fluorescence and RI. The overall detection of SLNs using ICG fluorescence was identical to RI (97.2 vs. 97.0 %, P = 0.88), and the combination of both methods achieved a significant improvement compared with RI alone (99.8 vs. 97.0 %, P \ 0.001). The detection rate for tumor-positive SLN was 93.3 % for ICG fluorescence and 90.0 % for RI, and the sensitivity of the ICG fluorescence method was 95.7 % (95 % CI 91.3-98.3, P = 0.11). The additional use of ICG significantly improved positive SLN detection for RI (97.2 vs. 90.0 %, P \ 0.001). There were no serious adverse events related to hypersensitivity to ICG. Conclusions. The ICG fluorescence method may be an acceptable alternative to SLN detection using RI in breast cancer.Sentinel lymph node (SLN) biopsy is the standard of care for axillary staging in breast cancer, and the dual tracer method using radioisotope (RI) and blue dye achieves the highest detection rates for SLN. 1-3 However, the applicability of RI is limited to large-volume centers with available RI facilities and nuclear medicine. The dye method is cost-effective, but it has drawbacks, such as a low detection rate and the need for significant physician skill and experience. 4 A novel method using indocyanine green (ICG) fluorescence was developed in

This retrospective study clarifies the prevalence and risk factors for BM and SRE in Japanese breast cancer patients. Our results show the importance of considering subtype in the care of BM and SRE.