Work

Immunofluorescence and targeted removal of the axillary sentinel lymph node in early-stage breast cancer: a simple, safe and effective anatomical approach

Year: 2025

Type: article

Abstract: The reference technique for axillary sentinel lymph node (SLN) detection in women with breast cancer uses the radioactive marker, technetium (Tc99m), which makes ambulatory surgery difficult and carries a risk of irradiation to the patient and the medical teams. The aim of this study was to investigate the feasibility of using immunofluorescence (IF), a new non-radioactive technique, for SLN detection in women with early-stage breast cancer (ESBC). Patients were included if they were suffering from ESBC (T1/T2 N0) or ductal carcinoma in situ. The SLN was first detected using IF with indocyanine green and was then confirmed using Tc99m. A total of 268 women with ESBC were included (median age: 61.4 years). Tumour location in the breast correlated with SLN location according to the anatomic classification ABCD, with >75% of tumours located in the outer quadrants of the breast. IF was positive in 96% of cases and allowed precise anatomic location of the SLN. The SLN was located in zone A in 87.7% of patients and zone B in 10.1%, which corresponds to the path of the lateral thoracic vein. Only 2.2% of tumours were in zone C and none were in zone D. Rate of failure of detection by IF alone was 4.1%, associated with a mean BMI of 26.8 kg/m 2 . IF is an economic, non-invasive, non-radioactive technique for SLN detection in ESBC. Surgeons should be aware of this new, alternative procedure so that it can be used more widely in the future.

Source: Clinical Surgical Oncology

DOI: 10.1016/j.cson.2025.100109