Sustainable Breast Cancer Surgery: A Promising Step Towards Eco-Friendly Oncologic Care

As the healthcare industry confronts its significant environmental impact, innovative approaches to surgical practices are gaining traction. A recent pilot study suggests that sustainable breast cancer surgery is feasible, preserving high sentinel node detection rates while potentially reducing the carbon footprint of oncologic care. This approach focuses on minimizing waste, utilizing reusable resources, and streamlining the patient journey.

What is Sustainable Breast Cancer Surgery?

Sustainable breast cancer surgery involves implementing environmentally conscious practices throughout the surgical process. This includes strategies to reduce resource consumption, minimize waste generation, and explore alternatives to traditional, potentially harmful materials. The core principles guiding this approach are often summarized by the “5Rs”: reduce, reuse, recycle, rethink, and research.

Key Elements of the Sustainable Approach

A pilot study, conducted between September 2024 and May 2025, evaluated a series of interventions in 34 women undergoing breast cancer surgery . These interventions included:

• Indocyanine Green for Sentinel Lymph Node Biopsy: Utilizing indocyanine green as an alternative to technetium-99m for mapping sentinel lymph nodes.
• Local Anesthesia with Intravenous Sedation: Reducing the need for general anesthesia, which can have a higher environmental impact.
• Waste Minimization: Implementing strategies to reduce the amount of disposable materials used during surgery.
• Reusable Gowns, Drapes, and Instruments: Replacing disposable items with reusable alternatives.
• Segregation of Non-Infectious Plastic Waste: Properly sorting plastic waste for recycling.

Sentinel Node Biopsy and Mapping Techniques

A crucial component of breast cancer surgery is determining whether the cancer has spread to the lymph nodes. Sentinel node biopsy is a procedure used to identify the first lymph nodes to which cancer cells are likely to spread. Traditionally, technetium-99m has been used for mapping these nodes, but the study explored indocyanine green as a potentially more sustainable alternative.

The study found that sentinel lymph node identification reached 100% in the technetium-99m group and 94.1% in the indocyanine green group, suggesting comparable effectiveness .

Benefits Beyond Environmental Impact

The sustainable surgical pathway also demonstrated potential benefits for patients. Patients undergoing the green protocol avoided preoperative hospitalization and radiotracer administration. A significant proportion (58.8%) were discharged on the same day , indicating a streamlined patient experience.

The Importance of Sustainability in Surgical Care

The authors emphasize the urgency of addressing the environmental impact of healthcare, particularly in the context of climate change. Surgical care contributes significantly to carbon emissions and waste generation. Breast cancer surgery, as a common surgical procedure, presents a practical setting for testing and implementing sustainable strategies .

Future Directions

While this pilot study provides promising preliminary results, further research is needed to fully quantify the environmental benefits of sustainable breast cancer surgery and to assess its long-term feasibility. Continued investigation into alternatives like indocyanine green for sentinel node mapping is also warranted. Integrating sustainable practices into surgical oncology can contribute to both environmental stewardship and improved patient care.

Key Takeaways

• Sustainable breast cancer surgery is a feasible approach that can reduce the environmental impact of oncologic care.
• Indocyanine green shows promise as a viable alternative to technetium-99m for sentinel lymph node mapping.
• Sustainable practices can potentially streamline the patient journey and reduce resource utilization.
• Further research is needed to optimize and expand the implementation of sustainable surgical protocols.