Intraoperative indocyanine green fluorescence guidance for excision of nonpalpable breast cancer

BACKGROUND: Different techniques have been used for the guidance of nonpalpable breast cancer (NBC), but none of them has yet achieved perfect results. The aim of this study was to evaluate the feasibility of indocyanine green (ICG) fluorescence-guided nonpalpable breast cancer lesion excision (IFNLE), to introduce an alternative technique. METHODS: The data about 56 patients with preoperatively diagnosed NBCs operated with the help of intraoperative IFNLE between November of 2010 and September of 2014 were retrospectively analyzed. RESULTS: ICG fluorescence localized all lesions at surgery. Re-excision due to positive resection margins was necessary in two patients (3.6 %; 2/56) with ductal carcinoma in situ (DCIS) at the surgical margins. Mastectomy was necessary in one patient (1.8 %; 1/56) due to multifocal invasive carcinoma. The mean volume of the excised tissue was 38.2 ± 16.5 cm(3). CONCLUSIONS: IFNLE is a technically applicable and clinically acceptable procedure whenever a breast cancer needs image-guided excision.