Preoperative localization of sentinel lymph nodes using intradermal microbubbles and contrast-enhanced ultrasonography in patients with breast cancer
- 21 October 2009
- journal article
- research article
- Published by Oxford University Press (OUP) in British Journal of Surgery
- Vol. 96 (11), 1295-1299
- https://doi.org/10.1002/bjs.6725
Abstract
Background Sentinel lymph node (SLN) biopsy is the standard procedure for axillary staging in early breast cancer. Lymphatic imaging after intraparenchymal microbubble injection has been reported in animal models. The aim of this study was to identify and localize SLNs before surgery by contrast-enhanced ultrasonography after intradermal injection of microbubbles in patients with breast cancer. Methods Fifty-four consecutive, consenting patients with primary breast cancer were recruited. Patients received a periareolar intradermal injection of microbubble contrast agent. Breast lymphatics were visualized by ultrasonography and followed to identify putative axillary SLNs. A guidewire was deployed to localize the SLN. The next day, patients underwent standard tumour excision and SLN biopsy. Results SLNs were identified and guidewires inserted in 48 patients. In these patients operative findings confirmed that the wired lymph nodes were SLNs. The sensitivity of SLN detection, compared with radioisotope and blue dye, was 89 per cent. Five patients were found to have metastases in SLNs. In these patients the SLNs were identified correctly and localized before surgery with guidewires. Conclusion SLNs may be identified and localized before surgery using contrast-enhanced ultrasonography after injection of microbubbles.Keywords
This publication has 12 references indexed in Scilit:
- Breast Cancer Patients with Extra-Axillary Sentinel Nodes Only may be Spared Axillary Lymph Node DissectionAnnals of Surgical Oncology, 2008
- The value of sentinel lymph node biopsy in ductal carcinoma in situ (DCIS) and DCIS with microinvasion of the breastEuropean Journal of Surgical Oncology, 2008
- Concordance of Peritumoral Technetium 99M Colloid and Subareolar Blue Dye Injection in Breast Cancer Sentinel Lymph Node BiopsyJournal of Surgical Research, 2007
- Ultrasound contrast agents: An overviewEuropean Journal of Radiology, 2006
- Role of Sonography in the Diagnosis of Axillary Lymph Node Metastases in Breast Cancer: A Systematic ReviewAmerican Journal of Roentgenology, 2006
- Prolonged skin staining after intradermal use of patent blue in sentinel lymph node biopsy for breast cancerEuropean Journal of Surgical Oncology, 2005
- Sentinel Lymph Nodes in a Swine Model with Melanoma: Contrast-enhanced Lymphatic USRadiology, 2004
- A Randomized Comparison of Sentinel-Node Biopsy with Routine Axillary Dissection in Breast CancerThe New England Journal of Medicine, 2003
- Lymphoscintigraphic identification of sentinel lymph nodes: clinical evaluation of 0.22-micron filtration of Tc-99m sulfur colloid.Radiology, 1998
- Technical Details of Intraoperative Lymphatic Mapping for Early Stage MelanomaArchives of Surgery, 1992