ICG-only Sentinel Lymph Node Biopsy in Breast Cancer: A Prospective UK Cohort Demonstrating Consistent…

Cohort studyAnnals of surgical oncology· Jul 2026

ICG-only Sentinel Lymph Node Biopsy in Breast Cancer: A Prospective UK Cohort Demonstrating Consistent Detection Across Patient and Tumour Characteristics-A Follow-on to the INFLUENCE Trial.

Vassilis Pitsinis, Nadia Khitab, Lee Jordan … Jennifer Smith

Breast SurgeryCohort studyClinical practiceQ1IF 2.1

Indocyanine green-only tracer detected sentinel lymph nodes in 97.7% of breast cancer procedures.

ICG-only Sentinel Lymph Node Biopsy in Breast Cancer: A Prospective UK Cohort Demonstrating Consistent Detection Across Patient and Tumour Characteristics-A Follow-on to the INFLUENCE Trial.

Vassilis Pitsinis … Jennifer Smith

Annals of surgical oncology · Jul 2026 · Q1 in Surgery

Background

Sentinel lymph node biopsy (sentinel lymph node biopsy) using dual tracer techniques remains the gold standard for axillary staging in early breast cancer.

Methods

A prospective single-centre cohort study was conducted including 300 consecutive sentinel lymph node biopsy procedures across 292 unique patients using indocyanine green as the sole tracer.

n = 300 consecutive SLNB procedures

Results

found the sentinel node in nearly all cases, a strong single-tracer alternative to dual mapping

Procedural nodal detec

99.7%

ICG fluorescent nodal

97.7%

More results

Median surgeon-pathologist nodal concordance was 100% (IQR 50-100%), with complete count agreement in 50.7% of procedures.

Detection was not influenced by age, body mass index (BMI), tumour size, or procedure type.

Operative time increased significantly with BMI (p = 0.0118) and breast-conserving surgery (p < 0.0001).

“

Conclusion · 1 of 3

This large UK prospective series demonstrates that indocyanine green-only fluorescence guidance is safe, efficient, and reproducible, with high procedural and nodal detection rates.

Conclusion · 2 of 3

Naked-eye visibility of indocyanine green was observed in a subset of cases, further supporting its practicality. Performance was consistent across surgical procedures and patient BMI.

Conclusion · 3 of 3

These findings support broader adoption of indocyanine green as a single tracer for sentinel lymph node biopsy.

ICG-only Sentinel Lymph Node Biopsy in Breast Cancer: A Prospective UK Cohort Demonstrating Consistent Detection Across Patient and Tumour Characteristics-A Follow-on to the INFLUENCE Trial.

ICG-only Sentinel Lymph Node Biopsy in Breast Cancer: A Prospective UK Cohort Demonstrating Consistent Detection Across Patient and Tumour Characteristics-A Follow-on to the INFLUENCE Trial.

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