Abstract
Axillary dissection is sometimes avoided when there is a micro-metastasis in one or two sentinel lymph nodes (SLN). It is better to make sure that there is no metastasis in the non-SLN, especially in the cases in which irradiation will not performed as post-operative additional therapy. In this study, we adopted indocyanine green (ICG) fluorescence method and one-step nucleic acid amplification (OSNA) method to the cases in which micrometastasis of SLNs was seen, and examined whether these combined methods could reduce the false negative rate of non-SLN metastasis. Among 28 cases with SLN micrometastasis, the positive rate of non-SLN metastasis by using the ICG and OSNA 14.3% (4/28). The rate was suppressed to 8.3% (2/24) when the 24 cases of 28 (85.7%) in which two or more lymph nodes were detected as SLNs. The positive rate of non-SLN metastasis by using dye method was almost equal to ICG fluorescence method (8.3%, 1/12). The detection rate of two or more SLNs by dye method was much lower than that by ICG (42.9%, 12/28). We conclude that combining the ICG fluorescence method, which is able to identify more than 2 SLNs with a high ratio, and the OSNA method could reduce the false-negative rate of non-SLN metastasis.
