Description
Fluorescence-guided breast cancer surgery uses fluorescent dyes, such as indocyanine green (ICG), to illuminate cancerous tissues and lymph nodes, aiding surgeons in precisely identifying and removing tumors. This technique improves surgical outcomes by enhancing the visualization of cancerous areas, reducing the chances of leaving residual cancer cells behind.
Summary Listen
- The speaker introduces themselves as an oncoplastic surgeon focused on both oncological cure and cosmetic restoration of the breast, aiming to improve quality of life for women. They highlight the paradigm shift in breast surgery towards organ-based oncology for achieving excellence in outcomes. Breast conservation therapy (BCT) is emphasized as superior in early breast cancer and equivalent in advanced cases, though mastectomy rates remain high in India due to late presentation.
- The speaker emphasizes the shift in breast cancer treatment to a multi-modality approach involving surgery, systemic therapy, and radiotherapy, with sequencing depending on the cancer's stage and biology. Genomics and genetics play a crucial role, with genomics scores determining recurrence risk and genetic testing identifying targets for treatment and germline mutations leading to hereditary breast and ovarian cancer syndrome.
- Fluorescence-guided breast surgery is presented as a significant advancement, with indocyanine green (ICG) being the most commonly used fluorescent dye. ICG lymphangiography is used to visualize the lymphatic system and assess vascularity. The technique involves injecting the dye into the skin of the breast or upper limb and using a specialized camera for visualization.
- ICG lymphangiography has multiple uses, including sentinel lymph node biopsy, reverse axillary mapping, and lymphovenous bypass. It helps accurately identify sentinel lymph nodes, safeguard arm lymphatics during axillary lymph node dissection, and bypass damaged lymphatics to prevent lymphedema. Intravenous ICG enables vascularity assessment, aiding in reconstructive procedures by identifying areas of poor perfusion.
- The presentation also highlights how ICG facilitates various oncoplastic breast surgery procedures, presenting examples of challenging cases where fluorescence guidance helped in revisions and complex reconstructions. The importance of a multi-disciplinary team and additional technologies alongside ICG is emphasized for optimal outcomes and minimizing complications.
- Finally, the speaker notes that another potential "game changer" is robotic and minimally invasive breast surgery, which they consider discussing in the future.
Sample Certificate
About the Speakers
Dr. Anushree Vartak
Senior Consultant Breast Surgical Oncology, Yashoda Superspeciality and Cancer Institutes, Ghaziabad
Financial Disclosure
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