Occult lesion localization by indocyanine green fluorescence for nonpalpable breast cancer

One third of operated breast cancers are clinically occult.1 Nonpalpable breast cancers (NPBC) require accurate intraoperative guidance to achieve complete tumor removal.1 Incomplete removal of lesions increases the rate of reexcision, worsening patient's discomfort, and cosmetic outcomes.1 Localization techniques suffer from various limitations. Indocyanine green (ICG) fluorescence is commonly used for intraoperative identification of sentinel lymph nodes (SLN).2 Its pertinence for NPBC is still underestimated. Darkness required in surgery room with available cameras has been a limitation for its use. We evaluated ICG method for NPBC localization, guided by a probe in ambient light, inspired by radioguided occult lesion localization (ROLL).