Advantage of contrast-enhanced ultrasound guided sentinel lymph node biopsy in early-stage breast cancer, one node might be enough: a prospective cohort study.

Abstract

Objective the purpose of this study is proving the contrast-enhanced ultrasound (CEUS) identified sentinel lymph node (SLN) could accurately represent the axillary nodes status in early-stage breast cancer. Method A total of 109 consecutive consenting patients with clinical node negative and T1-2 breast cancer were included in this study. All patients received CEUS to identify SLN before surgery and deploying a guidewire to locate the SLN in those who were CEUS explored successfully. All patients underwent sentinel lymph node biopsy (SLNB), and blue dye was also used to help in tracing sentinel lymph node during the surgery. Whether to perform axillary lymph node dissection (ALND) depends on the intraoperative pathological result of the SLN identified by CEUS (CE-SLN). Comparing the pathological results of the CE-SLN with the remaining dyed SLN and axillary dissection nodes. Result 4 patients was failed to identify the CE-SLN, the detection rate of the CEUS is 96.3%. Among the 105 successful patients, 18 were CE-SLN positive by intraoperative frozen section, another one with CE-SLN micrometastasis was diagnosed by paraffin section. No additional lymph node metastases were found for all CE-SLN negative patients, the false negative rate of CEUS-guided SLNB is 0%. Conclusion For patients with clinical node negative and small tumor burden breast cancer, SLN located by CEUS can accurately represent the status of axillary lymph nodes.