# Near-Infrared Fluorescence for Precision Breast Surgery in Nonpalpable Lesions: A Case Report

## TL;DR

Near-infrared fluorescence imaging helps surgeons precisely locate non-palpable breast lesions during surgery, offering a safer and more effective alternative to traditional methods.

## Contribution

This case report demonstrates the feasibility of using fluorescence-guided surgery for non-palpable breast lesions with a modified ICG solution.

## Key findings

- Fluorescence-guided surgery enabled real-time visualization and localization of a non-palpable breast lesion.
- The technique supported intraoperative decision-making and improved surgical workflow integration.
- The case outcome supports the potential of FGS as a superior alternative to conventional localization methods.

## Abstract

Accurate localization of non-palpable breast lesions remains challenging in clinical practice, and conventional methods carry procedural and patient-comfort limitations. Near-infrared (NIR) fluorescence imaging via indocyanine green (ICG) provides an innovative approach as a surgical adjunct for real-time, intraoperative visualization of target anatomy. In the context of performing safe surgery, fluorescence-guided surgery (FGS) effectively delivers a safe, feasible, and reproducible technique to localize non-palpable breast nodules, sparing the nuisances of suboptimal contemporary alternatives.

This is the case of a 47-year-old woman with a BI-RADS 4, non-palpable left breast lesion, who underwent ultrasound-guided injection of a modified ICG solution immediately before surgery. Real-time fluorescence provided delineation of the lesion, and guided skin incision, dissection trajectory, and depth control. This approach underscores the technical feasibility, workflow integration, and intraoperative decision support conveyed by FGS in non-palpable breast lesions. The favorable outcomes of the present case report align with superior outcomes reported in the literature. Nonetheless, a larger, systematic comparison with established localization techniques is warranted to define indications, accuracy, and resource implications for broader surgical adoption.