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How Fluorescence Imaging Helps in Breast Cancer Surgery

“Doctor… will I lose my breast?”

“Has the cancer spread?”

“Will my arm swell after surgery?”

These are some of the first questions I hear when I meet women who have recently been diagnosed with breast cancer.

If you are reading this after hearing the words “You have breast cancer,” I understand how overwhelming this time can be. Most women come to me with fear, confusion and dozens of unanswered questions.

Before we discuss surgery or treatment, my first priority is to help you understand what is happening inside your body and why I recommend a particular treatment.

When you understand the reason behind each step, the journey becomes much less frightening.

Recently, I introduced the Irillic Fluorescence Imaging System at Panacea Clinic, Nagpur. Many patients ask me,

“Doctor, what exactly is this machine, and how will it help me?”

Instead of explaining the machine first, let me explain the problem it helps me solve during breast cancer surgery.

Every Woman's Breast Cancer Is Different

One of the biggest misconceptions about breast cancer is that every woman needs the same surgery.

That simply isn’t true.

Some women can undergo a lumpectomy, where I remove only the cancer along with a small margin of healthy tissue while preserving the rest of the breast.

Others may need a mastectomy, where removing the entire breast is the safest option.

The right treatment depends on several factors, including the size of the tumour, its location, biopsy results, imaging findings and your overall health.

My goal is always the same.

Treat the cancer safely while preserving as much healthy tissue as possible whenever it is medically appropriate.

But before deciding the best surgery, I need to answer one very important question.

Has the cancer remained inside the breast, or has it started travelling outside it?

To understand that, let me explain something that most people have never heard about.

Understanding Your Body's Natural Drainage System

Imagine your house during heavy rain.

Rainwater falls everywhere, but without proper drainage pipes, the water starts collecting around the house.

Eventually, everything becomes flooded.

Your body works in a similar way.

Every day, a small amount of extra fluid collects around your tissues. This is completely normal. But that fluid cannot stay there forever. It needs to be collected and returned to your bloodstream.

Your body has a natural drainage network that performs this job.

This network is called the lymphatic system.

Think of it as thousands of tiny drainage pipes running throughout your body.

As the fluid travels through these tiny pathways, it passes through small filters called lymph nodes.

What Are Lymph Nodes?

I often explain lymph nodes to my patients using a simple example.

Imagine you are travelling on a highway.

Along the way, you pass through security checkpoints or toll plazas.

These checkpoints inspect what is passing through before allowing it to move ahead.

Lymph nodes work in a similar way.

They filter the fluid travelling through your lymphatic system and help your body’s immune cells fight infections.

So lymph nodes are not something abnormal.

They are an important part of your body’s natural defence system.

Now let us connect this to breast cancer.

Why Do I Need to Check Your Armpit When the Cancer Is in Your Breast?

This is probably the question I hear most often.

“Doctor, cancer breast mein hai… toh aap armpit kyun check karte hain?”

It is a very logical question.

Your breast has its own lymphatic drainage pathways, and many of these pathways naturally lead towards the lymph nodes in your armpit.

Now imagine a small leaf floating in a stream.

Wherever the water flows, the leaf follows.

Cancer cells can sometimes behave similarly.

If some cancer cells begin moving outside the breast, they may travel through these natural drainage pathways.

One of the first places they may reach is the lymph nodes in the armpit.

This does not mean the cancer has spread in every patient.

But it does mean I need to check these lymph nodes carefully before deciding the next step in your treatment.

Do I Need to Remove All the Lymph Nodes?

Fortunately, no.

Many years ago, surgeons commonly removed a large number of lymph nodes from the armpit to check whether cancer had spread.

Today, breast cancer surgery has become much more precise.

We now know that removing more lymph nodes than necessary can increase the risk of long-term problems such as lymphedema, a condition in which the arm may become swollen because its natural drainage system has been disrupted.

That is why my approach is different.

My goal is not to remove more tissue.

My goal is to remove only what is necessary while protecting healthy structures whenever it is safe to do so.

But that brings us to another important question.

If there are many lymph nodes in the armpit, how do I know which one to examine first?

The First Checkpoint Is the Most Important

Imagine you are driving from Nagpur to Mumbai.

You will cross several toll plazas during your journey.

But there will always be one toll plaza that comes first.

If I wanted to know whether a vehicle had travelled from Nagpur towards Mumbai, checking the first toll plaza would give me the earliest clue.

The lymphatic system works in much the same way.

Fluid leaving the breast usually reaches one or a few lymph nodes before the others.

These are called sentinel lymph nodes.

Don’t worry about remembering the medical name.

Simply think of them as the first checkpoint on the road leaving the breast.

If these first lymph nodes do not contain cancer cells, many women can avoid more extensive lymph node surgery.

The next question is…

How do I find these first lymph nodes during surgery?

That is where modern fluorescence imaging has changed the way I can perform breast cancer surgery.

How Does the Irillic Fluorescence Imaging System Help in Breast Cancer Surgery?

Now that you understand why I need to examine the lymph nodes, let me explain how I find them.

Many years ago, surgeons mainly relied on a radioactive tracer, a blue dye, or sometimes both to identify the lymph nodes that drain the breast. These methods are still used today and have helped thousands of women receive successful treatment.

However, medical technology has continued to improve.

The Irillic Fluorescence Imaging System gives me another way to identify these important lymph nodes during surgery.

Before I begin looking for the lymph nodes, I inject a very small amount of a fluorescent dye called Indocyanine Green (ICG) near the breast.

This dye enters the same natural drainage pathways we discussed earlier.

Although the dye cannot be seen with the naked eye, the Irillic camera uses a special near-infrared light to detect it.

On my monitor, I can see the pathway the dye is taking through the lymphatic vessels.

Think of it like using Google Maps.

Instead of guessing which road leads to your destination, you can clearly see the correct route.

Similarly, the Irillic system allows me to follow the lymphatic pathway and identify the first lymph node that needs to be examined.

One important thing I always explain to my patients is this:

The machine does not detect cancer.

Its job is to help me accurately identify the lymph node that should be removed for testing.

Once that lymph node is removed, it is carefully examined under a microscope by a pathologist. That is how we confirm whether cancer cells are present.

In other words, the technology helps guide my surgery, while the laboratory provides the final diagnosis.

Why Is This Helpful for You?

Patients often ask me,

“Doctor, if the older method already works, why use this technology?”

That is a fair question.

The biggest advantage is not that the machine replaces surgical experience.

It doesn’t.

Instead, it gives me better visual information while I am operating.

Rather than relying only on experience or indirect methods, I can actually see the lymphatic pathway in real time.

This additional information helps me perform the surgery more precisely.

The ICG fluorescence technique also does not require a radioactive tracer itself, making it another valuable option in suitable patients.

As with every aspect of breast cancer treatment, I decide which technique is most appropriate after understanding your individual condition.

"Doctor, Will My Arm Swell After Surgery?"

This is one of the biggest concerns women share with me before surgery.

Many patients ask,

“Doctor, surgery ke baad mera haath normal rahega na?”

Most women recover without developing significant arm swelling.

However, I believe every patient should understand why this can sometimes happen.

Remember the drainage system we discussed earlier?

Your breast has its own drainage pathways.

Your arm also has its own drainage pathways.

Many of these pathways meet around the armpit.

Sometimes, when lymph nodes need to be removed because of cancer, some of these drainage pathways may also be affected.

If the fluid from your arm cannot drain normally, it may begin collecting there.

This condition is called lymphedema.

You may notice that one arm feels heavier than the other.

Your bangles or watch may feel tighter.

Your blouse sleeve may suddenly feel snug on one side.

Some women also experience tightness, discomfort or difficulty lifting the arm above the shoulder.

Not every woman develops lymphedema.

The risk depends on several factors, including the extent of surgery, the number of lymph nodes removed and whether radiation therapy is also required.

That is why my approach is always to treat the cancer effectively while preserving healthy tissues whenever it is medically safe to do so.

Can We Protect the Drainage Pathways of the Arm?

In selected patients, yes.

This is another important role of the Irillic Fluorescence Imaging System.

Imagine two highways meeting at one junction.

One highway carries traffic from the breast.

The other carries traffic from the arm.

Without proper signs, telling them apart would be difficult.

Now imagine those roads lighting up on a navigation screen. You can immediately see which road leads where.

Fluorescence imaging works in a similar way.

It helps me better understand the lymphatic pathways around the armpit during certain breast cancer surgeries. This technique is medically known as Axillary Reverse Mapping, but you don’t need to remember that name.

The important point is this.

Whenever it is safe from a cancer treatment perspective, I try to identify and preserve the healthy drainage pathways that help remove fluid from your arm.

However, there is one principle I never compromise on.

Treating your cancer safely always comes first.

If I believe a lymph node needs to be removed because it may contain cancer cells, I will remove it. Technology should never compromise cancer treatment. Instead, it helps me make better-informed decisions while keeping your long-term recovery in mind.

What If I Need Breast Reconstruction?

Some women who undergo a mastectomy also choose breast reconstruction, either immediately or at a later stage. During reconstruction, the skin and tissue need a healthy blood supply to heal properly.

Think of planting a young tree. Even if the soil is good, the tree will struggle if its roots do not receive enough water.

Similarly, reconstructed tissue needs enough blood to survive and heal.

The Irillic system allows me to assess blood flow during suitable reconstructive procedures.

If I notice an area receiving less blood than expected, I can make adjustments while you are still in the operating room.

Again, the technology does not replace experience. It simply gives me more information to help me make better decisions during surgery.

Does My Treatment End After Surgery?

Not at all.

Breast cancer treatment doesn’t end the day your surgery is completed.

Recovery and follow-up are equally important.

Most women recover smoothly, but I continue to monitor your healing during follow-up visits.

If you develop symptoms such as arm heaviness, swelling, tightness or reduced movement, I may recommend further evaluation.

In selected patients, the Irillic Fluorescence Imaging System can also help after surgery by showing how lymphatic fluid is moving through the arm.

This helps me understand whether the drainage pathways are functioning normally or whether they have been affected.

It is important to remember that the machine does not treat lymphedema.

Instead, it helps me assess the problem more accurately so I can recommend the most appropriate treatment or rehabilitation plan.

Why Does This Matter for Women in Nagpur?

Until recently, women often associated advanced fluorescence-guided breast cancer surgery with large cancer centres in metropolitan cities.

Many patients travelled long distances simply because they believed advanced technology was only available elsewhere.

My decision to introduce the Irillic Fluorescence Imaging System at Panacea Clinic was driven by one simple goal.

To make advanced breast cancer care more accessible for women in Nagpur and nearby regions.

At the same time, I want to reassure you that technology alone does not improve outcomes.

A machine cannot replace careful planning, surgical experience or clinical judgement. Every woman who comes to me has a different diagnosis, different concerns and different treatment needs.

Some patients benefit from fluorescence-guided surgery. Others may not need it at all.

My responsibility is to recommend the treatment that is most appropriate for your cancer.

A Final Message

If you have recently been diagnosed with breast cancer, please remember one thing.

You do not need to understand every medical term or every new technology before beginning treatment.

That is my responsibility.

Your responsibility is to ask questions, understand your options and make informed decisions with your treating team.

The Irillic Fluorescence Imaging System is one of several advanced tools I use to help perform breast cancer surgery with greater precision in suitable patients.

But the most important part of your treatment is never the machine.

It is you.

Every decision I make, from choosing between a lumpectomy and a mastectomy to deciding whether fluorescence imaging will benefit you, is guided by one goal.

To treat your cancer safely while helping you recover with the best possible quality of life.

If you have questions about breast cancer surgery or would like to understand which treatment option is right for you, I encourage you to consult a qualified breast cancer specialist. A detailed discussion often provides far more clarity than searching the internet alone.

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