Reply letter to 'what is the clinical relevance of discordance between radioisotope alone and indocyanine green in sentinel lymph node biopsy for breast cancer?'

摘要

We thank Mr. Ahmed for his interest in our validation study on the indocyanine green (ICG) method for identifying the sentinel node (SN) in breast cancer. We appreciate his comments. In reply to his observation on the identification rate with radiocolloid alone, at our Institute we use only the radiocol-loid method, without blue dye. In fact we consider the radio-colloid method as the gold standard as in our hands it identifies the SN more reliably than the blue dye method. We are aware that in many centers the "dual technique" is standard, but we have used radiocolloids together with lym-phoscintigraphy for over 15 years, with over 22,000 SNBs performed and have detected the SN in over 99% of cases." Our ICG study was powered to determine whether the ICG method is equivalent to the radiocolloid method in terms of its ability to detect SNs. We assessed concordance between the two methods, to determine whether ICG can be effectively used alone to identify the SN, and hence be used in centers without a nuclear medicine facility. For this reason we avoided mention of pathological status of the SNs found.