Meta-analysis of the application value of indocyanine green fluorescence imaging in guiding sentinel lymph node biopsy for breast cancer.

Objective: The main objective of this study was to compare the application value of indocyanine green fluorescence imaging (ICGFI) and its combined tracing method with the blue dye method in guiding sentinel lymph node biopsy for breast cancer.

Materials And Methods: A computerized search of the Pubmed, Embase, Web of Science, and Cochrane Library databases was conducted to identify all relevant literature on ICGFI compared to the sole methylene blue (MB) tracing method in guiding sentinel lymph node biopsy for breast cancer. The search was performed up until May 2023. After assessing the quality of the included studies, a meta-analysis was conducted using STATA 12.0 software.

Results: A total of 11 relevant studies were included in this research. The analysis results showed that, in terms of the detection rate, the ICGFI group had a higher detection rate to the MB group [odds ratio (OR) = 8.64, 95% CI: 5.46-13.66, P = 0.000], and had a higher quantity compared to the MB group [weighted mean difference (WMD) = 0.72, 95% CI 0.31-1.13, P = 0.001], and it also had a lower false-negative rate [OR = 0.10, 95% CI 0.02-0.43, P = 0.002]. However, there was no statistically significant difference in the positive detection rate, and sensitivity comparison.

Conclusion: The indocyanine green fluorescence imaging and tracing method for sentinel lymph node biopsy for breast cancer are simple and effective, and they are well suited for clinical use. A multicenter randomized controlled trial with a large sample size should be conducted in the future for further validation of the method.