Aydogan Fatih, Ozben Volkan, Aytac Erman, Yilmaz Halit, Cercel Ali, Celik Varol
Department of General Surgery, Istanbul University Cerrahpasa Medical School, Istanbul, Turkey.
Breast Care (Basel). 2012 Feb;7(1):48-51. doi: 10.1159/000336497. Epub 2012 Feb 13.
Currently employed techniques for the localization of nonpalpable breast lesions suffer from various limitations. In this paper, we report on 2 patients in order to introduce an alternative technique, indocyanine green fluorescence-guided occult lesion localization (IFOLL), and determine its applicability for the surgical removal of this type of breast lesions. CASE REPORTS: Preoperatively, one of the patients had a needle biopsy-proven diagnosis of breast cancer, and the other one had suspicious findings for malignancy. Lesion localization was performed within 1 h before surgery under ultrasonography control by injecting 2 ml and 0.2 ml of indocyanine green into the lesion and its subcutaneous tissue projection, respectively. During surgery, the site of skin incision and the resection margins were identified by observing the area of indocyanine-derived fluorescence under the guidance of a near-infrared-sensitive camera. In both cases, the breast lesion was correctly localized, and the area of fluorescence corresponded well to the site of the lesions. Subsequent surgical excision was successful with no complications. On histopathologic examination, the surgical margins were found to be clear. CONCLUSION: IFOLL seems to be a technically applicable and clinically acceptable procedure for the removal of nonpalpable breast cancer.
目前用于定位不可触及乳腺病变的技术存在各种局限性。在本文中，我们报告2例患者，以介绍一种替代技术，即吲哚菁绿荧光引导隐匿性病变定位（IFOLL），并确定其在手术切除此类乳腺病变中的适用性。病例报告：术前，其中1例患者经针吸活检确诊为乳腺癌，另一例有恶性可疑表现。在手术前1小时内，在超声引导下，分别向病变及其皮下组织投影处注射2 ml和0.2 ml吲哚菁绿进行病变定位。手术过程中，在近红外敏感相机的引导下，通过观察吲哚菁产生的荧光区域来确定皮肤切口部位和切除边缘。在这两例中，乳腺病变均被正确定位，荧光区域与病变部位吻合良好。随后的手术切除成功，无并发症。组织病理学检查发现手术切缘清晰。结论：IFOLL似乎是一种技术上可行且临床上可接受的切除不可触及乳腺癌的方法。
