New techniques versus standard mapping for sentinel lymph node biopsy in breast cancer: a systematic review and meta-analysis.
Nicola RoccoNunzio VelottiMartina PontilloAntonio VitielloGiovanna BerardiAntonello AccursoStefania MasoneMario MusellaPublished in: Updates in surgery (2023)
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.
Keyphrases
- sentinel lymph node
- lymph node
- fluorescence imaging
- neoadjuvant chemotherapy
- squamous cell carcinoma
- iron oxide
- small cell lung cancer
- early stage
- systematic review
- clinical practice
- photodynamic therapy
- case control
- high resolution
- bioinformatics analysis
- electronic health record
- randomized controlled trial
- big data
- ultrasound guided
- high density
- locally advanced
- data analysis