Submit Manuscript | http://medcraveonline.com Introduction The sentinel lymph node (SLN) is defned as the frst lymph node receiving lymphatic drainage from the breast and represents the actual nodal status. 1 Currently, SLN biopsy is a routine procedure for early stage breast cancer. SLN biopsy is based on an ordered dissemination of tumor cells from peritumoral lymphatics to the SLN, and then to more distant lymph nodes. 2 Clinical identifcation of these nodes is usually performed by injecting a blue dye and a radioisotope into the peritumoral site. Labeled lymph nodes are surgically excised and histologically examined for the presence of disease. 1 Identifcation and biopsy of the SLN can correctly indicate the status of the draining lymph node basin. Nowdays SNL biopsy is the standard of care for staging the axilla and and decreases the morbidity related to axillary lymphadenectomy (LND). 2 The most important aspect of SLN biopsy is appropriate selection of patients that will beneft from this minimally invasive procedure. 2 Axillary lymph node status is the most important prognostic factor for early-stage breast cancer. The orderly spread of breast carcinoma theory came into question with publication of the prospective NSABP B-04 Trial in which it was reported that the addition of LND to mastectomy had no efect on disease-free survival or overall survival. 3 Those fndings indicate that the disease might already be systemic when it disseminates to regional lymph nodes. Nevertheless, regional lymph node status is critically important for precisely tailoring adjuvant treatment and evaluating prognosis. 1 The performance of SLN depends signifcantly on surgeon experience. Currently the gold standard for SLN biopsy is by using a blue dye and lymphoscintigraphy with a radioisotope (RI), usually technetium (Tc-99m). Generally Tc-99m is injected into the ipsilateral subareolar plexus. 1 The RI method requires expensive equipment, authorized radiation protection areas, and access of the nuclear medicine department to RI. These logistic and legislative issues limit SLN biopsy using RI to high-volume centers in developed countries. Since there are some logistical problems as the ones mentioned before, researchers are looking for alternative markers, such as indocyanine green (ICG). 4 The near-infrared (NIR) fuorescence imaging system uses the characteristic fuorescence spectra of ICG within an optical window. NIR/ICG fuorescence imaging visualizes subcutaneous lymphatic fow and allows the surgeon to directly observe the axillary fuorescent SLN. Although the fuorescence of ICG cannot be directly visualized with the naked eye, it can be confrmed on the monitor in real-time through a platform for near-infrared fuorescence imaging which is less expensive than RI method. 4 The ICG fuorescence method has valid diagnostic performance for SLN detection. This technique shows a trend toward better axilla staging and may be a useful alternative to RI for SLN biopsy. Several recent meta-analyses demonstrated that ICG-guided SLN biopsy achieved a high detection rate for SLN and was viable for the detection of SLN metastasis. 5 We present our serie of cases performing the ICG fuorescence method as an alternative way to identify the SNL, using the technology VS3 Iridium in EleVision™ IR platform (Medtronic, Minneapolis MN) that ofers high-defnition visualization with fuorescence imaging. VS3 Iridium is designed to work with ICG which has excitation at 805 nm and emission band between 825 nm and 850 nm. VS3 Iridium provides excitation light to the surgical feld to excite the dye molecules and captures emission from the ICG using an IR sensitive camera, and the Elevision TM platform has the capacity to electronically transform the image to green color. Methods Patients Between June 2019 and August 2022, a total of 70 consecutive patients with proven invasive breast cancer (T1-T2) and clinically node negative breast cancer (N0) were enrolled to undergo SLNB for localization using ICG at Pacífca Salud Hospital. All patients were diagnosed with breast cancer by core needle biopsy. Exclusion criteria included the following: defnite lymph node metastasis diagnosed by ultrasonography or biopsy and adverse reaction or allergy to ICG. The study was conducted in a single institution, where all procedures were J Cancer Prev Curr Res. 2022;13(5):125‒127. 125 ©2022 Cukier et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially. Sentinel node identifcation with indocyanine green in early stage breast cancer in a multi-ethnic Latin American population Volume 13 Issue 5 - 2022 Moises Cukier, Homero Rodríguez-Zentner, Emmy Arrue Division of General Surgery, Department of General Surgery, Pacifca Salud Hospital, Panama City, Panama Correspondence: Moises Cukier, Division of General Surgery, Department of General Surgery, Pacifca Salud Hospital, Consultorios Punta Pacifca, 4t foor, offce 407, Blvd Pacífca S/N, Panama, Rep of Panama, Tel +(507) 62081664, Email Received: September 17, 2022 | Published: September 29, 2022 Abstract Background/Aim: The purpose of this series of cases was to describe the use and feasibility of indocyanine green (ICG) fuorescence for localization of sentinel lymph node in early- stage breast cancer. Methods and patients: Sentinel lymph node biopsy using indocyanine green with fuorescence guided surgery using Medtronic’s EleVision™ IR platform, was performed on a total of 70 consecutive patients. Results: ICG successfully identifed all 87 lymph nodes excised in 70 surgeries. With a detection rate of 97.14%, the ICG method detected an average of 1.42 SLNs in 68 of 70 patients. Conclusion: Therefore, ICG fuorescence method is safe and efective addition in early breast cancer clinical staging. Journal of Cancer Prevention & Current Research Research Article Open Access