Indocyanine green (ICG) fluorescence imaging is increasingly used in breast cancer surgery to visualize lymphatic drainage, identify sentinel lymph nodes, and assess tissue perfusion during reconstruction. Proper dosing and timing of ICG administration are essential to achieve optimal near-infrared fluorescence imaging during the procedure.
This dosing and timing chart provides practical guidance for ICG use in breast cancer surgery, including recommended injection techniques, dosage ranges, and expected fluorescence detection times for sentinel lymph node mapping and breast reconstruction perfusion assessment.
Dye administration should be subcutaneous into periareolar region of each quadrant.
Dilution (25 mg in 10 mL of sterile water - 2.5mg/mL):
Yes
Requires Flush with Sterile Water:
No
Proposed Dosage:
1 mL
Injection Time:
At start of procedure.
First Indocyanine Green Detection:
Five to 10 minutes after administration
Indocyanine Green Duration:
Stable during surgery. Slowly diffuses through lymphatics
Camera Requirements (handheld device, laparoscope or both):
Handheld
Tips & Tricks:
Total 4 mL (1 mL per periareolar quadrant). Gentle, circular motion massaging can be performed to distribute dye.
SPECIAL CONSIDERATIONS
ALWAYS dilute with sterile water
ALWAYS flush with normal saline
Max dose is 2 mg/kg (e.g.: 120 mg or 4.8 reconstituted flasks of 25 mg/mL of ICG)
*For 0.1 and 0.2 mL doses, utilize an insulin syringe to draw/administer volumen.
DISCLAIMERS
Doses are device-dependent
The above dosage and timing information have been collated from worldwide surgeons expert in these procedures and is based on their recommendations and is not evidence-based.
All dosages have been adjusted to the U.S. recommended dilution of 25mg of ICG in 10mL of sterile water
Approval for listed indications may vary according to country.
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