Tumor localization and surgical margins identification in breast cancer using ICG-fluorescence imaging

Introduction: The accuracy of tumor localisation and perioperative margin assessment in breast cancer (BC) is of critical importance in surgical treatment planning. Currently, gross pathological evaluation, frozen section, imprint cytology, intraoperative ultrasound, and two-view specimen mammography are used for intraoperative margins evaluation. The most commonly used methods in pre-operative marking of non-palpable breast tumor are wire-guided localization, radioguided occult lesion localization, carbonmarking and intraoperative ultrasound. These procedures have several disadvantages, are labor intensive, not fully reliable, time consuming, may lead to poor cosmesis, and therefore novel strategies are necessary. Fluorescence imaging (FI) has emerged as a new technique for improving tumor detection and to guide surgical resection in different oncological conditions. The pourpose of this study are to evaluate the role of FI using an intraoperative intravenous injection of free indocyanine green (ICG) for the localization of breast tumors cancer and evaluate if it can be utilized to assess the residual disease of the surgical specimen.