{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T05:14:26Z","timestamp":1778130866080,"version":"3.51.4"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sentinel lymph node biopsy is the gold standard for axillary staging in early breast cancer. The conventional dual-tracer technique using technetium-99m (Tc-99m) and blue dye is highly effective but limited by radiation exposure and logistical complexity. Indocyanine green (ICG) fluorescence imaging offers a radiation-free, real-time alternative. This study aimed to assess the diagnostic performance and clinical feasibility of ICG-guided SLNB compared with the standard Tc-99m-nanocolloid method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This prospective, open label, single center paired diagnostic comparison trial was conducted at the Department of Surgery, University of Debrecen Clinical Centre, Hungary. Eligible patients had biopsy-confirmed ductal carcinoma\n                      <jats:italic>in situ<\/jats:italic>\n                      or clinically node-negative invasive breast cancer (T1\u2013T3) undergoing breast-conserving surgery or mastectomy. Periareolar injections of 99mTc-nanocolloid and 5 mg ICG were performed according to standardized international SLNB protocols. Lymphatic mapping was achieved with gamma-radiation detecting and near-infrared fluorescence imaging. Sentinel node detection rate, number of retrieved nodes, metastatic involvement, and adverse events were recorded and analyzed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 106 patients were included. ICG fluorescence achieved a sentinel node detection rate of 90,6%, compared with 97,1% for Tc-99m. A median of 2,1 lymph nodes were excised per patient. 21.7% received neoadjuvant systemic therapy and 63.2% had breast conserving surgery. The overall per-patient sentinel lymph node (SLN) detection rate was 90.6% with indocyanine green (ICG), 97.1% with technetium-99m (Tc-99m), and 98.1% with the combined technique. On a per-node basis (n = 221), detection rates were 88.2%, 83.7%, and 100%, respectively. Among patients with positive SLNs (n = 34), metastatic node detection was 94.1% using ICG, 79.4% with Tc-99m, and 100% with the combined approach. In both upfront surgery and neoadjuvant subgroups, no statistically significant differences were observed between detection methods (p &amp;gt; 0.05); however, interpretation of neoadjuvant results was limited by the small sample size. No ICG-related complications or adverse events were reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ICG fluorescence-guided SLNB alone is a safe, effective, and radiation-free alternative to conventional radioisotope mapping. Its high detection accuracy, simplicity, and real-time visualization support its integration into standard breast cancer surgery protocols. Further multicenter studies are warranted to validate long-term oncological outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1817708","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T04:54:29Z","timestamp":1778129669000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative analysis of indocyanine green and technetium-99m for sentinel lymph node localization in breast cancer \u2013 institutional experience"],"prefix":"10.3389","volume":"16","author":[{"given":"Csaba","family":"K\u00f3sa","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Debrecen Clinical Centre","place":["Debrecen, Hungary"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hajnalka","family":"Kulcs\u00e1r","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Debrecen Clinical 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