Objectives The efficacy and utility of neoadjuvant chemotherapy (NAC) for Inflammatory breast cancer (IBC) are demonstrated. In node-negative patients after NAC, sentinel lymph node biopsy (SLNB) can be considered but not in IBC because of a low identification rate (IR) and a high false-negative rate(FNR). We aim to evaluate the SLNB identification fluorescence technique in this IBC population.

Methods Between 2015 and 2019, data of all patients with NAC for carcinoma of the breast clinically classified as inflammatory (T4d) and without palpably suspicious nodes who underwent an SLNB during the definitive modified radical mastectomy with axillary clearance were retrospectively reviewed. Under general anesthesia 5 ml/12.5 mg of Infracyanine ® (Indocyanine green) were injected circumferentially around the areola; followed by a 15 min massage of the breast. The axillary incision was then performed and lymphatic vessels were visualized by a near-infrared camera. The sentinel node(s) were identified as being fluorescent and removed separately. After SLNB biopsy, mastectomy and axillary dissection were fully performed.

Results A total of 22 patients with IBC underwent SLNB after NAC using the above-mentioned technique. The median age at the time of diagnosis was 44 years (range 25–62 years). The identification rate is 86% (19/22 patients). The false-negative rate was16% (2 patients among the 12 who had negative SLNB had a positive axilla lymph node examination).

Conclusions The data of this study are encouraging but a larger sample is required. We do not have a clear explanation of why fluorescence provides better IR and lower FNR.