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Operative reports were reviewed to determine sentinel lymph node (SLN) identification rates with ICG (fluorescent) and Tc<jats:sup>99<\/jats:sup> (radioactive). Pathology reports were reviewed to determine the pathology of excised SLNs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>One hundred and nineteen SLNBs were performed on 117 patients. At least one radioactive or fluorescent SLN was identified in 93.2% of all patients. The mean number of SLNs retrieved per SLNB was 1.6 (fluorescent, 1.5; radioactive, 1.5). Of all excised SLNs, 89.4% were fluorescent, 88.4% were radioactive, and 81.9% were both fluorescent and radioactive. SLN metastases were present in 26 patients (22.2%); of SLNs identified with metastases on pathologic examination, 87.2% were fluorescent, 74.4% were radioactive, and 71.8% were both radioactive and fluorescent. Two patients (1.7%) experienced skin flap necrosis and one patient (0.9%) experienced prolonged skin discoloration. No patients experienced allergic reactions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>This study demonstrates that SLN identification rates using ICG and Tc<jats:sup>99<\/jats:sup> are comparable to those using blue dye and Tc<jats:sup>99<\/jats:sup>. Thus, ICG is a suitable alternative for blue dye. Future work should assess if ICG is a suitable tracer for SLNB in low-resource settings where Tc<jats:sup>99<\/jats:sup> is not available.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s10549-025-07767-7","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T08:58:45Z","timestamp":1751014725000},"page":"151-159","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The use of indocyanine green and technetium-99 for dual-tracer sentinel lymph node biopsy in breast cancer"],"prefix":"10.1007","volume":"213","author":[{"given":"Madison","family":"Kolbow","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianyun","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Cerrato Grande","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Schelomo","family":"Marmor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Witt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydne","family":"Muratore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd M.","family":"Tuttle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane Y. 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