Sentinel lymph node detection in breast surgery using ICG vs. 99Tc: A comparison among different diagnostic protocols

Cancer Science & Therapy

ISSN: 1948-5956

Open Access

Sentinel lymph node detection in breast surgery using ICG vs. 99Tc: A comparison among different diagnostic protocols

2nd World Congress on Breast Cancer

September 19-21, 2016 Phoenix, USA

Cattin F, Fogacci T, Frisoni G L, Fabiocchi L, Dellachiesa L, Semprini G and Samorani D

Posters & Accepted Abstracts: J Cancer Sci Ther

Abstract :

Background: Equivalence in sensibility and specificity between 99Tc and ICG (Indocyanine Green) in sentinel lymph node detection for breast cancer is nowadays demonstrated. The radioactive medium of contrast needs to be injected a Nuclear Medicine Department. On the contrary, ICG can be injected directly in the operatory theatre. This implies that, using 99Tc, patients must undergo two travels instead than the one required using ICG. Aim of our study is to determine the economic expenses linked to the two possible ways to detect sentinel lymph nodes in breast surgery. Materials & Methods: 291 Patients (01/2013-07/2014) of the Breast Unit of the Santarcangelo di Romagna Hospital underwent both a 99Tc injection and a ICG injection during the validation study of the ICG technique. Patients received 99Tc in the Nuclear Medicine of the Cesena Hospital (the nearest to the Santarcangelo one). The cost for each kilometer has been calculated (considering a 0.2788 â?¬ refund for kilometer), as well as the carbon footprint (considering a mean CO2 emission of 118.2 g/ km). 99Tc injection has a cost, all considered, of 1500â?¬ for one patient, and just 100â?¬ are due to the tracer itself. ICG costs 302â?¬ each patient, which become 102â?¬ after the first 250 patients, considering the infrared detecting machine amortization. Results: An overall amount of 49778.5Km has been required when using 99Tc, on the contrary IDG has required 18861.7Km. This implies a carbon footprint of 5.88 tons of CO2 when using 99Tc and of 2.22 tons of CO2 when using ICG. The overall amount of costs of the 99Tc pathway has been 450363.62â?¬. Considering the same patients, the overall cost of the ICG pathway has been 84883.39â?¬. This means that ICG costs are 18.84% of the 99Tc costs. Conclusions: ICG is a safe tracer, as it has a sensibility and specificity equal to the radioactive one. It is cheaper as the traditional radioactive techniques as well, especially if surgery is performed in peripheric centers or in hospitals which do not own a Nuclear Medicine Department. Considering our results, we can suggest the use of ICG for the sentinel lymph node detection in breast surgery, not only as safe technique, but also as cost-effective one.

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