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Perinodal fibrosis developed after ultrasonography‐guided core‐needle biopsy of a contrast‐enhanced ultrasound‐detected sentinel axillary node interferes with subsequent surgical sentinel node dissection
Author(s) -
Serquiz Nicoli,
Moro Luciano,
Menossi Carlos A.,
Almeida Natalie R.,
Baccarin Gabrielle,
Paiva Silva Geisilene R.,
Shinzato Julia Y.,
Derchain Sophie,
Jales Rodrigo M.
Publication year - 2019
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.22765
Subject(s) - medicine , palpation , biopsy , radiology , sentinel lymph node , breast cancer , dissection (medical) , fibrosis , ultrasound , surgery , cancer , pathology
Objective To evaluate perinodal fibrosis after 14‐gauge staging core‐needle biopsy (CNB) of the axillary sentinel lymph node (SLN) identified using contrast‐enhanced ultrasonography (CEUS) and its interference with subsequent surgical SLN dissection in breast cancer patients. Methods Frequencies or means of main clinical, sonographic, pathological, and surgical characteristics were calculated. We also compared patient groups with and without perinodal pathological fibrosis. Results Forty‐eight patients who underwent CEUS + CNB and axillary surgery were eligible for this cross‐sectional study. Axillary surgical specimens showed perinodal fibrosis in 9/48 (18.7%) patients. Interference with SLN dissection was reported in 4/48 (8.3%) patients (two hematomas, three abnormal palpation findings, and four difficult dissections). The overall surgical detection rate of SLN was 43/48 (89.6%). In the majority of cases, perinodal fibrosis was described as moderate (4/9 [44.4%]) or severe (4/9 [44.4%]). The mean time elapsed between CEUS + CNB and axillary dissection was shorter in patients with perinodal fibrosis ( P = .04). Interference with SLN dissection was only reported in patients with perinodal fibrosis ( P < .001). Surgical SLN detection was successful in all nine cases in which perinodal pathological fibrosis or interference with SLN dissection was reported. Conclusion Perinodal fibrosis may impair the surgical SLN dissection in early stage breast cancer patients who were staged using CEUS + CNB using a14‐gauge needle.