UHFUS Characterization of Normal Lymphatic Anatomy

This is a prospective pilot study of breast cancer patients undergoing axillary lymph node dissection (ALND) or sentinel lymph node biopsy (SLNB). Participants will undergo ultra-high frequency ultrasound (UHFUS) imaging with indocyanine green (ICG) dye to map lymphatic channels between the wrist and elbow to investigate normal lymphatic anatomy in patients with breast cancer. Additionally, the study will evaluate the adverse reactions to indocyanine green (ICG) dye, characterize variability in ultrasonographic characteristics of lymphatic channels, investigate the correlation of indocyanine green (ICG) pathways and UHFUS characteristics of lymphatic channels, and investigate the correlation of ICG lymphography patterns and patient demographics.

The primary study objective is to investigate normal lymphatic anatomy in patients with breast cancer using UHFUS. We hypothesize that normal lymphatic anatomy exhibits consistent ultrasonographic characteristics, and ICG lymphography can reliably correlate with UHFUS findings.

Inclusion criteria

• 1. Aged 18+ at the time of consent.
• 2. Confirmed breast cancer diagnosis
• 3. Planned ALND (CPT code: 38745) or SLNB (CPT code: 38900) for breast cancer treatment
• 4. Provision of a signed and dated informed consent form.
• 5. Stated willingness to comply with all study procedures and availability for the duration of the study.

Exclusion criteria

• 1. History of transient or permanent edema of the extremity, including edema ≥stage 1 per the International Society of Lymphology (ISL) staging system 15
• 2. History of prior axillary nodal surgery
• 3. History of any lymphatic disease or venous disease of the upper extremity, including deep venous thrombosis