Sentinel Lymph Node Biopsy using Indocyanine Green and Blue Dye in Male Breast Cancer: A Case Report of 5 Patients

Abstract Background: Male breast cancer is extremely rare and optimal treatments remain unclear. Most of research findings about breast cancer are derived from female patients and has not been rigorously investigated in male patients. The aim of article is to introduce the utility of indocyanine green (ICG) and blue dye mapping for sentinel lymph node (SLN) biopsy and to determine its clinical usefulness in male breast cancer. Case presentation: A total of 5 consecutive male breast cancer patients with clinical stage ranging from I to IIA in the Tongde Hospital of Zhejiang Province during March 2013 to May 2016 were included in the present study. All patients underwent SLN biopsy with ICG and blue dye. Planed surgical resection with axillary lymph node dissection was performed. Surgically excised sentinel nodes were subjected to conventional histopathology. All of 5 cases with male breast cancer were successfully identified SLNs. Among them, 4 cases were detected by blue dye and all cases were detected by indocyanine green. A total of 10 SLNs were retrieved with an average nodal count of 2 per patient. Metastases were present in 2 nodes within 1 patients. Conclusions: These results provide evidence that the SLN biopsy mapping with ICG and blue dye is accurate in predicting axillary lymph nodes metastases and has the potential to be a reliable criteria for staging of the axilla in patients with male breast cancer.