Imperial College London
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Mr Daniel Richard Leff

Faculty of Medicine, Department of Surgery & Cancer

Reader in Breast Surgery
 
 
 
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Contact

 

d.leff Website

 
 
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Location

 

016Paterson WingSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Kedrzycki:2021:10.1245/s10434-020-09288-7,
author = {Kedrzycki, MS and Leiloglou, M and Ashrafian, H and Jiwa, N and Thiruchelvam, PTR and Elson, DS and Leff, DR},
doi = {10.1245/s10434-020-09288-7},
journal = {Annals of Surgical Oncology},
pages = {3738--3748},
title = {Meta-analysis comparing fluorescence imaging with radioisotope and blue dye-guided sentinel node identification for breast cancer surgery.},
url = {http://dx.doi.org/10.1245/s10434-020-09288-7},
volume = {28},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - INTRODUCTION: Conventional methods for axillary sentinel lymph node biopsy (SLNB) are fraught with complications such as allergic reactions, skin tattooing, radiation, and limitations on infrastructure. A novel technique has been developed for lymphatic mapping utilizing fluorescence imaging. This meta-analysis aims to compare the gold standard blue dye and radioisotope (BD-RI) technique with fluorescence-guided SLNB using indocyanine green (ICG). METHODS: This study was registered with PROSPERO (CRD42019129224). The MEDLINE, EMBASE, Scopus, and Web of Science databases were searched using the Medical Subject Heading (MESH) terms 'Surgery' AND 'Lymph node' AND 'Near infrared fluorescence' AND 'Indocyanine green'. Studies containing raw data on the sentinel node identification rate in breast cancer surgery were included. A heterogeneity test (using Cochran's Q) determined the use of fixed- or random-effects models for pooled odds ratios (OR). RESULTS: Overall, 1748 studies were screened, of which 10 met the inclusion criteria for meta-analysis. ICG was equivalent to radioisotope (RI) at sentinel node identification (OR 2.58, 95% confidence interval [CI] 0.35-19.08, p < 0.05) but superior to blue dye (BD) (OR 9.07, 95% CI 6.73-12.23, p < 0.05). Furthermore, ICG was superior to the gold standard BD-RI technique (OR 4.22, 95% CI 2.17-8.20, p < 0.001). CONCLUSION: Fluorescence imaging for axillary sentinel node identification with ICG is equivalent to the single technique using RI, and superior to the dual technique (RI-BD) and single technique with BD. Hospitals using RI and/or BD could consider changing their practice to ICG given the comparable efficacy and improved safety profile, as well as the lesser burden on hospital infrastructure.
AU  - Kedrzycki,MS
AU  - Leiloglou,M
AU  - Ashrafian,H
AU  - Jiwa,N
AU  - Thiruchelvam,PTR
AU  - Elson,DS
AU  - Leff,DR
DO  - 10.1245/s10434-020-09288-7
EP  - 3748
PY  - 2021///
SN  - 1068-9265
SP  - 3738
TI  - Meta-analysis comparing fluorescence imaging with radioisotope and blue dye-guided sentinel node identification for breast cancer surgery.
T2  - Annals of Surgical Oncology
UR  - http://dx.doi.org/10.1245/s10434-020-09288-7
UR  - https://www.ncbi.nlm.nih.gov/pubmed/33156466
UR  - https://link.springer.com/article/10.1245%2Fs10434-020-09288-7#article-info
UR  - http://hdl.handle.net/10044/1/84125
VL  - 28
ER  -
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