Contrast-Enhanced Ultrasound for Precise Sentinel Lymph Node Biopsy in Women with Early Breast Cancer: A Preliminary Study.

Yangyang Zhu,Dan Yang,Xiao Fan,Fang Nie,Tiantian Dong,Yingying Jia

doi:10.3390/diagnostics11112104

Yangyang Zhu, Dan Yang + Show 4 more

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https://doi.org/10.3390/diagnostics11112104

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Abstract

Background: Sentinel lymph node biopsy (SLNB), as a common method for axillary staging of early breast cancer, has gradually attracted people’s attention to the false-negative rate and postoperative complications. The aim of the study is to investigate the clinical value of preoperative contrast-enhanced ultrasound (CEUS) for intraoperative SLNB in early breast cancer patients. Methods: A total of 201 patients scheduled for SLNB from September 2018 to April 2021 were collected consecutively. Preoperative CEUS was used to identify sentinel lymph nodes (SLN) and lymphatic drainage in breast cancer patients. Results: The SLN identification rate of CEUS was 93.0% (187/201) and four lymphatic drainage patterns were found: single LC to single SLN (70.0%), multiple LCs to single SLN (8.0%), single LC to multiple SLNs (10.2%), and multiple LCs to multiple SLNs (11.8%). The Sen, Spe, PPV, NPV, AUC of CEUS, US and CEUS + US in diagnosis of SLNs were 82.7%, 80.4%, 73.8%, 87.4%, 0.815; 70.7%, 77.7%, 68.0%, 79.8%, 0.742; and 86.7%, 77.7%, 72.2%, 89.7%, 0.822, respectively. There was no statistically significant difference between the diagnostic performance of CEUS and CEUS + US (p = 0.630). Conclusions: CEUS can be used to preoperatively assess the lymphatic drainage patterns and the status of the SLNs in early breast cancer to assist precision intraoperative SLNB.

Highlights

Breast cancer is the most common malignancy in women [1], and axillary lymph nodes (ALNs) status occupies an important position in the diagnosis and prognostic assessment of breast cancer [2]
We investigated the feasibility of contrast-enhanced ultrasound (CEUS) for preoperative localization of lymphatic drainage to sentinel lymph nodes (SLN) and in diagnosing SLN metastasis for precise Sentinel lymph node biopsy (SLNB) in patients with breast cancer
All 201 patients enrolled in this study underwent CEUS, and no adverse reactions or complications due to contrast agents were observed within three months after the procedure

Summary

Introduction

Breast cancer is the most common malignancy in women [1], and axillary lymph nodes (ALNs) status occupies an important position in the diagnosis and prognostic assessment of breast cancer [2]. Axillary lymph node dissection (ALND) has been the staging procedure and treatment for ALNs in operable breast cancer patients until the 1990s. Sentinel lymph node biopsy (SLNB) has replaced ALND as the standard staging protocol for patients with negative clinical ALNs because of its advantages in terms of safety and recovery outcomes [4]. Sentinel lymph node biopsy (SLNB), as a common method for axillary staging of early breast cancer, has gradually attracted people’s attention to the false-negative rate and postoperative complications. Preoperative CEUS was used to identify sentinel lymph nodes (SLN) and lymphatic drainage in breast cancer patients.

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