[Use of indocyanine green angiography in oncological and reconstructive breast surgery]

Abstract

The Indocyanine green (ICG) is a soluble dye that is eliminated by the liver and excreted in bile. When illuminated by an near-infrared light, the ICG emits fluorescence in the near-infrared spectrum, which can be captured by a near-infrared camera-handled device. In case of intravenous injection, ICG may be used as a marker of skin perfusion. In case of interstitial injection, it may be useful for lymphatic network mapping. In oncological and reconstructive breast surgery, ICG is used for sentinel lymph node identification, to predict mastectomy skin flap necrosis, to assess the perfusion of free flaps in autologous reconstruction and for diagnosis and treatment of upper limb secondary lymphedema. Intraoperative indocyanine green fluorescence might also be used to guide the excision of nonpalpable breast cancer.

Keywords: Anastomose lymphatico-veineuse; Angiographie au vert d’indocyanine; Autologous reconstruction; Breast conserving surgery; DIEP; Ganglion sentinelle; Indocyanine green; Indocyanine green angiography; LVA; Lumpectomy; Lymphatic venous anastomosis; Lymphœdème secondaire; Mastectomie conservatrice de la peau; Mastectomie conservatrice de l’aréole; Mastectomie réductrice de l’étui cutané; Nipple-sparing mastectomy; Reconstruction mammaire autologue; Secondary lymphedema; Sentinel lymph node; Skin-reducing mastectomy; Skin-sparing mastectomy; Traitement conservateur du cancer du sein; Transfert de ganglions vascularisés; Tumorectomie; Vascularized lymph node transfer; Vert d’indocyanine.