Applications of ICG in Breast Cancer for Sentinel Lymph Node Mapping: A Scoping Review Protocol

Abstract

Objective: The objective of this scoping review is to evaluate the current literature on the use of Indocyanine Green (ICG) in sentinel lymph node (SLN) mapping for breast cancer patients. This review aims to assess the accuracy, efficacy, and safety of ICG in this context and to identify gaps in the existing research. The outcomes will contribute to the development of further research as part of a PhD project. Introduction: Breast cancer is the leading cause of morbidity and mortality worldwide. Accurate SLN mapping is crucial for staging and treatment planning in early-stage breast cancer. ICG has emerged as a promising agent for fluorescence imaging in SLN mapping. However, comprehensive assessment of its clinical utility, including accuracy and adverse effects, remains limited. This scoping review aims to consolidate evidence on the use of ICG in breast cancer SLN mapping. Inclusion criteria: Patients with early-stage breast cancer (T1, T2), selected T3 cases where sentinel lymph node biopsy is accurate, and clinically node-negative breast cancer. The intervention includes studies using ICG for SLN mapping and assessment of fluorescence imaging cameras. Methods: Five electronic databases will be searched (PubMed, EMBASE, MEDLINE, Web of Science, and SCOPUS) using search strategies developed in consultation with the academic supervisor. The search strategy is set to human studies published in English within the last 11 years. All retrieved citations will be imported to Zotero and then uploaded to Covidence for screening of titles, abstracts, and full text according to pre-specified inclusion criteria. Citations meeting the inclusion criteria for full-text review will have their data extracted by two independent reviewers, with disagreements resolved by discussion. A data extraction tool will be developed to capture full details about the participants, concept, and context, and findings relevant to the scoping review will be summarized. Keywords: Indocyanine Green, ICG, Sentinel Lymph Node, Breast Cancer, Fluorescence, Axillary Lymph Node Mapping, NIR