Outpatient revisits associated with three sentinel lymph node detection techniques for breast cancer: A propensity score weighted analysis

Clinical Surgical Oncology Pub Date : 2025-06-23 DOI:10.1016/j.cson.2025.100087

Michelle P. Sosa , Deirdre G. McNicholas , Arbelina B. Bebla , Seth Emont , Zhun Cao , Manu Tyagi , Craig Lipkin , Sommer Gunia

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Abstract

Introduction

This study evaluates whether near-infrared fluorescence (NIRF) imaging with indocyanine green (ICG) is associated with a lower outpatient (OP) revisit rate compared to isosulfan blue (IB) or methylene blue (MB) when combined with technetium-99m (Tc99m) for sentinel lymph node (SLN) mapping of breast cancer.

Materials and methods

This retrospective observational study included adult female patients with a breast cancer diagnosis who underwent SLN mapping and had an index OP discharge between July 1, 2017 and August 31, 2022 at a U.S. hospital contributing to the Premier Healthcare Database. Patients were grouped by SLN mapping method: IB + Tc99m, MB + Tc99m, and ICG + Tc99m. The primary outcome was OP revisit rates at 30, 60, and 90 days post-discharge. Propensity score weighting adjusted for differences in baseline characteristics.

Results

5.6 % (n = 60,068) of the 1,067,677 adult female patients with a breast cancer diagnosis underwent SLN mapping, and 54.9 % (n = 32,970) met the inclusion criteria. In the propensity-weighted sample (n = 2002), the ICG + Tc99m cohort had the lowest OP revisit rates at all time points compared to IB + Tc99m and MB + Tc99m: at 30 days, 36.4 % vs. 43.1 % vs. 43.2 %; at 60 days, 50.9 % vs. 55.8 % vs. 56.2 %; and at 90 days, 55.9 % vs. 59.7 % vs. 60.0 % (all p < .05). Adjusted odds ratios (aORs) confirmed the ICG + Tc99m cohort's reduced OP revisits: 30-day aOR, 0.74 (0.63–0.88); 60-day aOR, 0.80 (0.68–0.94); and 90-day aOR, 0.84 (0.71–0.99) (all p < .05).

Conclusion

NIRF with ICG + Tc99m was associated with significantly fewer OP revisits, suggesting that this method may improve patient outcomes and the continuum of care for breast cancer patients.

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与三种前哨淋巴结检测技术相关的门诊复诊：倾向评分加权分析

本研究评估近红外荧光（NIRF）成像与吲哚菁绿（ICG）相比，与异硫丹蓝（IB）或亚甲基蓝（MB）联合锝-99m （Tc99m）进行乳腺癌前哨淋巴结（SLN）定位时，是否与较低的门诊（OP）重访率相关。材料和方法本回顾性观察性研究纳入了2017年7月1日至2022年8月31日期间在美国一家医院接受SLN定位并有指数OP出院的乳腺癌成年女性患者，这些患者为Premier医疗数据库提供了资料。采用SLN作图法对患者进行分组：IB + Tc99m、MB + Tc99m、ICG + Tc99m。主要结果是出院后30,60和90天的OP重访率。结果在1,067,677例诊断为乳腺癌的成年女性患者中，5.6% （n = 60,068）进行了SLN定位，54.9% （n = 32,970）符合纳入标准。在倾向加权样本（n = 2002）中，与IB + Tc99m和MB + Tc99m相比，ICG + Tc99m队列在所有时间点的OP重访率最低：在30天，36.4%比43.1%比43.2%；60天，50.9% vs. 55.8% vs. 56.2%；在第90天，55.9% vs. 59.7% vs. 60.0% (p <；. 05)。调整后的优势比（aORs）证实ICG + tc9900万组的OP复诊次数减少：30天的aOR为0.74 (0.63-0.88)；60天aOR为0.80 (0.68-0.94)；90天aOR为0.84(0.71-0.99)(均p <；. 05)。结论ICG + Tc99m的nirf与OP复诊次数显著减少相关，提示该方法可改善患者预后和乳腺癌患者的持续护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Clinical Surgical Oncology

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