Department of Thyroid and Breast Surgery, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, No. 6, Huanghe Road, Changshu, 215500, Jiangsu, China.
Department of Ultrasonic Medicine, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu, China.
World J Surg Oncol. 2023 May 8;21(1):143. doi: 10.1186/s12957-023-03024-7.
This study evaluated the identification efficiency of contrast-enhanced ultrasound (CEUS) for sentinel lymph nodes (SLN) to accurately represent the axillary node status in early-stage breast cancer.
In total, 109 consecutive consenting patients with clinically node-negative and T1-2 breast cancer were included in this study. All patients received CEUS to identify SLN before surgery, and a guidewire was deployed to locate SLN in those who were successfully explored by CEUS. The patients underwent sentinel lymph node biopsy (SLNB), and the blue dye was used to trace SLN during the surgery. The decision to perform axillary lymph node dissection (ALND) depended on the intraoperative pathological identification of SLN by CEUS (CE-SLN). The concordance rate of pathological status between CE-SLN and dyed SLN was calculated.
The CEUS detection rate was 96.3%; CE-SLN failed in 4 patients. Among the remaining 105 successful identifications, 18 were CE-SLN positive by intraoperative frozen section, and one with CE-SLN micrometastasis was diagnosed by paraffin section. No additional lymph node metastases were found in CE-SLN-negative patients. The concordance rate of pathological status between CE-SLN and dyed SLN was 100%.
CEUS can accurately represent the status of axillary lymph nodes in patients with clinically node-negative and small tumor burden breast cancer.
本研究旨在评估超声造影（CEUS）对前哨淋巴结（SLN）的识别效率，以准确反映早期乳腺癌的腋窝淋巴结状态。
本研究共纳入 109 例临床淋巴结阴性且 T1-2 期乳腺癌患者。所有患者均在术前接受 CEUS 以识别 SLN，并在 CEUS 成功探查的患者中部署导丝以定位 SLN。患者接受前哨淋巴结活检（SLNB），术中使用蓝染剂追踪 SLN。CEUS （CE-SLN）术中识别 SLN 的病理结果决定是否进行腋窝淋巴结清扫术（ALND）。
CEUS 的检出率为 96.3%；4 例 CE-SLN 失败。在其余 105 例成功识别的患者中，18 例术中冰冻切片 CE-SLN 阳性，1 例 CE-SLN 微转移病例通过石蜡切片诊断。CE-SLN 阴性患者未发现额外的淋巴结转移。CE-SLN 和蓝染 SLN 的病理状态一致性率为 100%。
CEUS 可以准确反映临床淋巴结阴性且肿瘤负荷较小的乳腺癌患者的腋窝淋巴结状态。
