New techniques versus standard mapping for sentinel lymph node biopsy in breast cancer: a systematic review and meta-analysis

Updates Surg. 2023 Sep;75(6):1699-1710. doi: 10.1007/s13304-023-01560-1. Epub 2023 Jun 16.

Abstract

New tracers for sentinel lymph node biopsy (SLNB), as indocyanine green (ICG), superparamagnetic iron oxide (SPIO) and micro bubbles, have been recently introduced in clinical practice showing promising but variable results. We reviewed the available evidence comparing these new techniques with the standard tracers to evaluate their safety. To identify all available studies, a systematic search was performed in all electronic databases. Data regarding sample size, mean number of SLN harvested for patient, number of metastatic SLN and SLN identification rate of all studies were extracted. No significant differences were found in terms of SLNs identification rates between SPIO, RI and BD but with a higher identification rate with the use of ICG. No significant differences were also found for the number of metastatic lymph nodes identified between SPIO, RI and BD and the mean number of SLNs identified between SPIO and ICG versus conventional tracers. A statistically significant differences in favor of ICG was reported for the comparison between ICG and conventional tracers for the number of metastatic lymph nodes identified. Our meta-analysis demonstrates that the use of both ICG and SPIO for the pre-operative mapping of sentinel lymph nodes in breast cancer treatment is adequately effective.

Keywords: Breast cancer; Indocyanine green; Sentinel lymph node biopsy; Superparamagnetic iron oxide.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Breast Neoplasms* / pathology
  • Breast Neoplasms* / surgery
  • Coloring Agents
  • Female
  • Humans
  • Indocyanine Green
  • Lymph Nodes / pathology
  • Sentinel Lymph Node Biopsy / methods
  • Sentinel Lymph Node* / pathology
  • Sentinel Lymph Node* / surgery

Substances

  • Coloring Agents
  • ferric oxide
  • Indocyanine Green