Abstract: Objective To explore the clinical value of indocyanine green (ICG) fluorescence navigation combined with carbon nanoparticles (CNP) in sentinel lymph node biopsy (SLNB) for patients with early breast cancer. Methods A total of 294 early breast cancer patients with axillary node negative in Department of Breast Surgery, Foshan Hospital Affiliated to Sun Yat-Sen University from June 2013 to April 2016 were retrospectively analyzed. Of the patients, 149 cases underwent SLNB with ICG combined with CNP (combination group), while 145 cases underwent SLNB with methylene blue alone (MB group). If the intraoperative pathology results of sentinel lymph nodes (SLNs) were negative, axillary lymph node dissection (ALND) was avoided. The SLNs detection rate, detection number, metastatic SLNs detection rate in SLNB were compared between two groups. The influence of age and body mass index (BMI) on SLNs detection rate was also analyzed. Results In the combination group, subcutaneous lymphatic channels were successfully visualized in 145 patients, and the detection rate was 97.3% (145/149). The fluorescence of SLNs was successfully detected in 143 patients, and the detection rate was 95.9% (143/149). The detection rate of SLNs was higher in the combination group than that of methylene dye alone group (97.9% vs. 91.0%，χ2=6.902，P＜0.05). The average number of detected SLNs was higher in the combination group than that of methylene dye alone group (4.5±1.6 vs. 3.2±1.5，t=4.476，P＜0.05). Fifty-eight metastatic SLNs were found in 715 SLNs in the combination group (8.1%), and 26 in 544 SLNs in MB group (4.7%). The detection rate was significantly higher in the combination group than that of methylene dye alone group (χ2=13.714，P＜0.01). Age and BMI showed no influence on the detection rate and accuracy of SLNB in two groups (P > 0.05). Conclusion The combined tracing of ICG fluorescence and carbon nanoparticles for SLNB has showed a better stability and operability in patients with early breast cancer, which is recommended to be a new SLNB method.

Key words: breast neoplasms, sentinel lymph node biopsy, lymph node excision, indocyanine green, carbon nanoparticle, fluorescence navigation, methylene blue