Abstract

BackgroundThis preliminary study aimed to examine the feasibility of sentinel lymph node biopsy (SLNB) using contrast-enhanced ultrasound (CEUS) vs. indocyanine green fluorescence (ICG), combined with blue dye in patients with breast cancer.MethodsThis was a retrospective study of consecutive female patients with invasive stage I-III (based on pre-operative physical examination and imaging) primary breast cancer at the Peking Union Medical College Hospital between 01/2013 and 01/2015 who underwent preoperative SLNB by ICG + blue dye or CEUS + blue dye. The numbers of detected SLNs, detection rates, and recurrence-free survival (RFS) rates were compared between the two groups.ResultsA total of 443 patients were included. The detection rates of SLNs in the CEUS + blue dye and ICG + blue dye groups were 98.4 and 98.1%, respectively (P = 0.814). The average numbers of SLNs detected per patient showed no significant difference between the two groups (3.06 ± 1.33 and 3.12 ± 1.31 in the CEUS + blue dye and ICG + blue dye groups, respectively; P = 0.659). After a median follow-up of 46 months, five patients in the CEUS + blue dye group and 15 in the ICG + blue dye group had recurrence. RFS rates showed no significant difference (P = 0.55).ConclusionThis preliminary study suggests that CEUS + blue dye and ICG + blue dye are both feasible for SLN detection in breast cancer.

Highlights

  • This preliminary study aimed to examine the feasibility of sentinel lymph node biopsy (SLNB) using contrast-enhanced ultrasound (CEUS) vs. indocyanine green fluorescence (ICG), combined with blue dye in patients with breast cancer

  • Invasive breast cancer is of particular significance because of its propensity to spread to local lymph nodes and to other organs/sites

  • SLNB allows the first step of staging, and Axillary lymph node dissection (ALND) can be omitted in patients with negative SLNs, reducing the likelihood of complications [3]

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Summary

Introduction

This preliminary study aimed to examine the feasibility of sentinel lymph node biopsy (SLNB) using contrast-enhanced ultrasound (CEUS) vs. indocyanine green fluorescence (ICG), combined with blue dye in patients with breast cancer. Invasive breast cancer is of particular significance because of its propensity to spread to local lymph nodes and to other organs/sites. Axillary lymph nodes are the most common sites of regional metastasis, and sentinel lymph node (SLN) biopsy (SLNB) is necessary for tumor staging and prognosis. Axillary lymph node dissection (ALND) allows the sampling of lymph nodes but is associated with significant morbidities such as upper extremity numbness, infection, and lymphedema [3]. SLNB allows the first step of staging, and ALND can be omitted in patients with negative SLNs, reducing the likelihood of complications [3].

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