Enhancing Surgical Efficacy in Fibroadenoma Resection: A Novel Approach Utilizing Indocyanine Green Dye

Introduction: Fibroadenomas (FAs) are the most common benign breast tumors, and their detection is increasing globally. Traditional surgical excision, the standard of care, presents challenges in achieving precise margin delineation, which can lead to suboptimal cosmetic outcomes and the need for re-operation. This study evaluates the utility of indocyanine green (ICG) fluorescence-guided surgery to address these limitations by enhancing surgical precision and improving cosmetic results in FA resection. Aim This study aimed to evaluate the effectiveness of indocyanine green (ICG) dye injection for the surgical removal of breast fibroadenomas. The primary objectives were to enhance intraoperative tumor visualization, minimize the excision of healthy breast tissue, and improve surgical accuracy and cosmetic outcomes compared to conventional techniques. Setting: All patients were operated on in Moscow Russia. Materials and Methods A prospective case series was conducted in 2024, involving 24 female patients diagnosed with fibroadenoma. Under ultrasound guidance, 0.1 mL of ICG solution (2.5 mg/mL) was injected directly into the center of each fibroadenoma. A near-infrared (NIR) fluorescence imaging system was used for real-time tumor visualization. Outcome measures included the accuracy of tumor localization, completeness of excision (confirmed by histopathology), incidence of complications, and cosmetic outcomes assessed by both surgeon and patient. Results Complete excision with clear histopathological margins was achieved in all 24 cases (100%). No significant intraoperative or postoperative complications were reported. All patients expressed satisfaction with the cosmetic results. The ICG fluorescence guidance enabled clear identification of tumor margins, facilitating precise and complete tumor removal while preserving healthy breast tissue. Conclusions ICG-guided fibroadenoma excision is a safe and effective technique that significantly improves surgical precision and cosmetic outcomes. By enhancing intraoperative tumor visualization, it facilitates the preservation of healthy tissue and ensures complete tumor removal. Larger, randomized controlled trials are warranted to further validate these findings and establish standardized protocols for the routine use of ICG in benign breast surgery.