Open AccessIdentification of sentinel lymph nodes by contrast‐enhanced ultrasonography with Sonazoid in patients with breast cancer: a feasibility study in three hospitals
Author(s) -
Shimazu Kenzo,
Ito Toshikazu,
Uji Kumiko,
Miyake Tomohiro,
Aono Toyokazu,
Motomura Kazuyoshi,
Naoi Yasuto,
Shimomura Atsushi,
Shimoda Masafumi,
Kagara Naofumi,
Kim Seung Jin,
Noguchi Shinzaburo
Publication year - 2017
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.1142
Subject(s) - sentinel lymph node , medicine , breast cancer , biopsy , radiology , lymph node , lymph , nuclear medicine , cancer , surgery , pathology
Abstract The aim of this prospective study was to evaluate the feasibility of periareolar injection of the contrast agent Sonazoid ( SNZ ) followed by ultrasonography ( US ) for the identification of sentinel lymph node ( SLN ) in breast cancer patients with clinically negative node. Patients ( n = 100) with T1‐2N0M0 breast cancer received a periareolar injection of SNZ followed by US to identify contrast‐enhanced SLN . Each contrast‐enhanced SLN underwent fine needle aspiration cytology ( FNAC ) followed by SLN biopsy with a conventional method using blue dye and/or radiocolloid (B/R). In almost all cases, contrast‐enhanced lymphatic vessels were clearly visualized by US soon after the periareolar injection of SNZ and the SLN s were easily identified with an identification rate of 98% (98/100) for SNZ and 100% (100/100) for B/R. The number of SLN s identified by SNZ ( SNZ ‐ SLN ) (mean per patient, 1.52) was significantly lower than that identified by B/R (B/R‐ SLN ) (2.19) ( P < 0.0001). Twenty‐five patients with positive SLN s had at least one positive SNZ ‐ SLN . On a node‐by‐node basis, sensitivity, specificity, and accuracy of FNAC for SNZ ‐ SLN s ( n = 149) were 33.3%, 99.2%, and 85.9%, respectively. Identification of SLN by periareolar injection of SNZ is a technically simple method with an identification rate as high as 98%. SNZ ‐ SLN thus seems to be a good target for FNAC , but sensitivity of FNAC for SNZ ‐ SLN s needs to be improved.