The AAPS 102nd Annual Meeting

Differentiating Afferent Lymphatic Pathways Using Dual-Dye Technique During Immediate Lymphatic Reconstruction

Breast Cancer Related Lymphedema

Reverse Lymphatic Mapping

Immediate Lymphatic Reconstruction (ILR)

Lymphosomes

Describe benefits of utilizing indocyanine green (ICG) and Isosulfan Blue (ISB)

Differentiate lymphatic drainage from the proximal and distal lymphosomes of the upper extremity

Dual-Dye Imaging Technique

Lymphatic Drainage Assessment:

Asses distal (ICG) or proximal (ISB) drainage into axilla

26 breast cancer patients underwent ILR, 21 with dual dye

ICG (drainage from the distal extremity)

•Seen in 100% of patients

ISB (drainage from the proximal extremity)

•Seen in 61.9% of patients

Proximal and distal lymphatic channels show alternate drainage into the axilla.

Dual-dye allows for visualization of axillary lymphatic drainage by the breast and micro surgeon.

ICG is more reliable and identifiable.

Differentiating Afferent Lymphatic Pathways Using Dual-Dye Technique During Immediate Lymphatic Reconstruction