Feasibility of an indocyanine green-hyaluronic acid mixture (LuminoMark™) for targeting suspicious axillary lymph nodes in patients with breast cancer
Abstract Purpose During breast cancer surgery, the use of dyes such as indigo carmine, methylene blue, or indocyanine green (ICG) for targeting axillary lymph nodes (ALNs) under ultrasound guidance can result in rapid diffusion, complicated tissue differentiation, and disruption of staining. LuminoM...
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BMC
2024-12-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-024-13175-9 |
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| author | Jeeyeon Lee Byeongju Kang Jin Hyang Jung Hye Jung Kim Won Hwa Kim Jung Dug Yang Joon Seok Lee Yee Soo Chae Soo Jung Lee In Hee Lee Ji-Young Park Nora Jee-Young Park Ho Yong Park |
| author_facet | Jeeyeon Lee Byeongju Kang Jin Hyang Jung Hye Jung Kim Won Hwa Kim Jung Dug Yang Joon Seok Lee Yee Soo Chae Soo Jung Lee In Hee Lee Ji-Young Park Nora Jee-Young Park Ho Yong Park |
| author_sort | Jeeyeon Lee |
| collection | DOAJ |
| description | Abstract Purpose During breast cancer surgery, the use of dyes such as indigo carmine, methylene blue, or indocyanine green (ICG) for targeting axillary lymph nodes (ALNs) under ultrasound guidance can result in rapid diffusion, complicated tissue differentiation, and disruption of staining. LuminoMark™, a novel ICG-hyaluronic acid mixture, can provide real-time visualization and minimize dye spread, thereby ensuring a clear surgical field. The aim of our study was to evaluate the efficacy of LuminoMark™ for targeting ALNs in patients with breast cancer. Methods A total of 13 patients with breast cancer (mean age 56.5 years; 92.3% female) and suspicious ALNs underwent targeted axillary surgery (TAS) with activated charcoal and LuminoMark™ injected into the LNs in the surgical field. The clinicopathological variables of the patients and diagnostic performance were assessed. The LNs injected with LuminoMark™ were examined for consistency with sentinel LNs (SLNs) and non-SLNs, as well as with charcoal-tattooed LNs. Results The identification of SLNs took approximately 15.6 min from the start of skin incision, and it required 25.6 and 17.7 min, for charcoal-tattooed and LuminoMarkTM-illuminated LNs, respectively. The identification rate was 92.3% with charcoal and 100% with LuminoMark™. The concordance rate between LuminoMark™ illumination and SLNs was higher than that between charcoal tattooing and SLNs. The concordance rate between the two methods was 76.9% (n = 10). Three months after surgery, the charcoal tattoo remained visible on the skin; however, LuminoMark™ was not visible. Conclusion Although both methods demonstrated high detection rates, the rate was higher using LuminoMark™. As LuminoMark™ was administered directly into LNs, this improved the accuracy of identifying LNs. |
| format | Article |
| id | doaj-art-a210a9bc7e5e48078307d10fafdcc710 |
| institution | Kabale University |
| issn | 1471-2407 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj-art-a210a9bc7e5e48078307d10fafdcc7102025-01-05T12:33:10ZengBMCBMC Cancer1471-24072024-12-0124111010.1186/s12885-024-13175-9Feasibility of an indocyanine green-hyaluronic acid mixture (LuminoMark™) for targeting suspicious axillary lymph nodes in patients with breast cancerJeeyeon Lee0Byeongju Kang1Jin Hyang Jung2Hye Jung Kim3Won Hwa Kim4Jung Dug Yang5Joon Seok Lee6Yee Soo Chae7Soo Jung Lee8In Hee Lee9Ji-Young Park10Nora Jee-Young Park11Ho Yong Park12Department of Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok HospitalDepartment of Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok HospitalDepartment of Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok HospitalDepartment of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok HospitalDepartment of Radiology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok HospitalDepartment of Plastic Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok HospitalDepartment of Plastic Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok HospitalDepartment of Hematology and Oncology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok HospitalDepartment of Hematology and Oncology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok HospitalDepartment of Hematology and Oncology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok HospitalDepartment of Pathology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok HospitalDepartment of Pathology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok HospitalDepartment of Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok HospitalAbstract Purpose During breast cancer surgery, the use of dyes such as indigo carmine, methylene blue, or indocyanine green (ICG) for targeting axillary lymph nodes (ALNs) under ultrasound guidance can result in rapid diffusion, complicated tissue differentiation, and disruption of staining. LuminoMark™, a novel ICG-hyaluronic acid mixture, can provide real-time visualization and minimize dye spread, thereby ensuring a clear surgical field. The aim of our study was to evaluate the efficacy of LuminoMark™ for targeting ALNs in patients with breast cancer. Methods A total of 13 patients with breast cancer (mean age 56.5 years; 92.3% female) and suspicious ALNs underwent targeted axillary surgery (TAS) with activated charcoal and LuminoMark™ injected into the LNs in the surgical field. The clinicopathological variables of the patients and diagnostic performance were assessed. The LNs injected with LuminoMark™ were examined for consistency with sentinel LNs (SLNs) and non-SLNs, as well as with charcoal-tattooed LNs. Results The identification of SLNs took approximately 15.6 min from the start of skin incision, and it required 25.6 and 17.7 min, for charcoal-tattooed and LuminoMarkTM-illuminated LNs, respectively. The identification rate was 92.3% with charcoal and 100% with LuminoMark™. The concordance rate between LuminoMark™ illumination and SLNs was higher than that between charcoal tattooing and SLNs. The concordance rate between the two methods was 76.9% (n = 10). Three months after surgery, the charcoal tattoo remained visible on the skin; however, LuminoMark™ was not visible. Conclusion Although both methods demonstrated high detection rates, the rate was higher using LuminoMark™. As LuminoMark™ was administered directly into LNs, this improved the accuracy of identifying LNs.https://doi.org/10.1186/s12885-024-13175-9Breast neoplasmSentinel lymph nodeIndocyanine greenCharcoal |
| spellingShingle | Jeeyeon Lee Byeongju Kang Jin Hyang Jung Hye Jung Kim Won Hwa Kim Jung Dug Yang Joon Seok Lee Yee Soo Chae Soo Jung Lee In Hee Lee Ji-Young Park Nora Jee-Young Park Ho Yong Park Feasibility of an indocyanine green-hyaluronic acid mixture (LuminoMark™) for targeting suspicious axillary lymph nodes in patients with breast cancer BMC Cancer Breast neoplasm Sentinel lymph node Indocyanine green Charcoal |
| title | Feasibility of an indocyanine green-hyaluronic acid mixture (LuminoMark™) for targeting suspicious axillary lymph nodes in patients with breast cancer |
| title_full | Feasibility of an indocyanine green-hyaluronic acid mixture (LuminoMark™) for targeting suspicious axillary lymph nodes in patients with breast cancer |
| title_fullStr | Feasibility of an indocyanine green-hyaluronic acid mixture (LuminoMark™) for targeting suspicious axillary lymph nodes in patients with breast cancer |
| title_full_unstemmed | Feasibility of an indocyanine green-hyaluronic acid mixture (LuminoMark™) for targeting suspicious axillary lymph nodes in patients with breast cancer |
| title_short | Feasibility of an indocyanine green-hyaluronic acid mixture (LuminoMark™) for targeting suspicious axillary lymph nodes in patients with breast cancer |
| title_sort | feasibility of an indocyanine green hyaluronic acid mixture luminomark™ for targeting suspicious axillary lymph nodes in patients with breast cancer |
| topic | Breast neoplasm Sentinel lymph node Indocyanine green Charcoal |
| url | https://doi.org/10.1186/s12885-024-13175-9 |
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