Feasibility and efficiency of contrast enhanced ultrasound real time guided fine needle aspiration for sentinel lymph node of breast cancer

2021 ◽  
pp. 1-12
Author(s):  
Xian-Quan Shi ◽  
Huiming Zhang ◽  
Xi Liu ◽  
Yunyun Dong ◽  
Peipei Yang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Real Time ◽  
False Negative ◽  
False Negative Rate ◽  
Needle Aspiration ◽  
Contrast Enhanced Ultrasound ◽  
Fine Needle ◽  
Contrast Enhanced

AIM: To assess the feasibility and efficiency of contrast-enhanced ultrasound (CEUS) real-time guided fine needle aspiration (FNA) for sentinel lymph node (SLN) of breast cancer. MATERIALS AND METHODS: This retrospective study reviewed 21 breast cancer patients who scheduled for surgical resection performed CEUS real-time guided SLN-FNA and intraoperative SLN biopsy (SLNB). The success rate of CEUS real-time guided SLN-FNA was analyzed. The FNA diagnostic efficiency of SLN metastasis was analyzed compared to SLNB. RESULTS: Twenty-six SLNs were detected by intradermal CEUS whereas 130 SLNs were detected by SLNB. The median SLNs detected by intradermal CEUS (n = 1) and by SLNB (n = 5) was significantly difference (p <  0.001). All 26 CE-SLNs of 21 patients were successfully performed intradermal CEUS dual image real-time guided SLN-FNA including 5 SLNs of 4 patients which were difficult to distinguish in conventional ultrasound. Compared to SLNB, FNA found 2 of 5 cases of SLN metastasis, the diagnosis sensitivity, specificity, positive predictive value, negative predictive value, false negative rate, false positive rate and Yoden index were 40%, 100%, 100%, 84.2%, 60%, 0%and 40%, respectively. CONCLUSION: SLN-FNA real-time guided by dual CEUS image mode was technically feasible. Patients with a positive SLN-FNA should be advised to ALND without intraoperative SLNB according to Chinese surgeon and patients’ conservatism attitude. But a negative SLN-FNA did not obviate the need of conventional SLNB because of the high false negative rate.

scholarly journals Sentinel Lymph Node Biopsy in Early Breast Cancer Using the Indocyanine Green Fluorescence Technique: A Validation Study

2021 ◽  
Vol 20 (3) ◽  
Author(s):  
Loh Soon Khang ◽  
Suraya Baharudin ◽  
Juliana Abdul Latiff ◽  
Siti Aishah Mahamad Dom ◽  
Shahrun Niza Suhaimi
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Early Breast Cancer ◽  
Detection Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Lymph Node Biopsy ◽  
Blue Dye ◽  
Node Biopsy

INTRODUCTION: Introduction: Sentinel lymph node biopsy (SLNB) is now recognized as the standard of care for early breast cancer patients with negative axillary lymph nodes. Various approaches for Sentinel Lymph Node (SLN) identification using either the blue dye method or scintigraphy alone or their combination have been proposed. However, this method is costly and may not be applicable in certain developing countries. SLNB involving the use of indocyanine green (ICG) offers several advantages, and it is valid and safe when in direct comparison with the blue dye method and scintigraphy. Hence, we performed SLNB using this method in early breast cancer as the first center that involves the use of ICG in Malaysia. We performed validation study on this method with the aims to determine its sensitivity and safety profile. MATERIALS AND METHODS: This is a validation and non-randomised prospective observational study involving 20 patients underwent SLNB wherein ICG is used for localisation. The patients were recruited according to the recommendations stipulated in the Malaysia Clinical Practice Guideline. RESULT: The average number of SLNs removed per patient was 4.0 (range, 3–6) with sentinel lymph nodes detection rate at 98.75% (79/80). The false negative rate is at 5%. No adverse events were observed in all cases. CONCLUSION: The ICG fluorescence method is simple, reliable and safe. Moreover, it demonstrates a high SLN detection rate with a low false-negative rate, and it does not require a special instrument for radioisotope use.

scholarly journals Preoperative Tumor Biopsy Results In More Detected Sentinel Node Than Intraoperative Biopsy In Breast Cancer Patients

2020 ◽  
Author(s):  
chenxi yuan ◽  
xinzhao wang ◽  
zhaoyun liu ◽  
chao li ◽  
mengxue bian ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
False Negative ◽  
False Negative Rate ◽  
Excisional Biopsy ◽  
Breast Cancer Surgery ◽  
Tumor Biopsy ◽  
Tracer Injection ◽  
Negative Rate

Abstract Background Sentinel lymph node biopsy (SLNB) acts as a vital role in the breast cancer surgery, and the identified number of sentinel nodes determines its accuracy to represent the status of axillae. There remain two tumor biopsy modes in breast cancer, preoperative and intraoperative biopsy. We compared the effect of the two different biopsies on the result of SLNB. Methods Patients with clinical stage T1-3, N0 tumor were enrolled in this study. 53% received preoperative tumor biopsy and 47% received intraoperative excisional biopsy. For search of the sentinel lymph node, patients received dual tracer injection. The number of SLNs detected and false negative rate were compared between groups. Results 204 patients were enrolled, 108 received preoperative tumor biopsy and 96 received intraoperative excisional biopsy. Among all the patients, 160 received ALND following SLNB. Preoperative tumor biopsy detected more SLNs than intraoperative biopsy (mean rank 113.87 vs. 90.9, p= 0.004). False negative rate in preoperative and intraoperative tumor biopsy was 3% and 18%, respectively. Conclusions Patients in preoperative tumor biopsy group could find more SLNs than intraoperative biopsy patients. False negative rate was also lower in preoperative biopsy group.

scholarly journals Factors that affect the false negative rate of sentinel lymph node mapping with methylene blue dye alone in breast cancer

2019 ◽  
Vol 47 (10) ◽  
pp. 4841-4853 ◽  
Author(s):  
Huang Li ◽  
Zhang Jun ◽  
Ge Zhi-Cheng ◽  
Qu Xiang
Keyword(s):  
Breast Cancer ◽  
Methylene Blue ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
False Negative ◽  
False Negative Rate ◽  
Blue Dye ◽  
Methylene Blue Dye ◽  
Clinicopathological Factors

Objective This study aimed to investigate the clinicopathological factors of the false negative rate (FNR) and accuracy of sentinel lymph node biopsy (SLNB) mapping with 1% methylene blue dye (MBD) alone, and to examine how to reduce the FNR in patients with breast cancer. Methods A total of 365 patients with invasive breast carcinoma who received axillary lymph node dissection after SLNB were retrospectively analyzed. SLNB was performed with 2 to 5 mL of 1% MBD. We studied the clinicopathological factors that could affect the FNR of SLNB. Results The identification rate of sentinel lymph nodes (SLNs) was 98.3% (359/365) and the FNR of SLNB was 10.4% (16/154). Multivariate analysis showed that the number of dissected SLNs and metastatic lymph nodes were independent predictive factors for the FNR of SLNB. The FNR in patients with 1, 2, 3, and ≥4 SLNs was 23.53%, 15.79%, 3.85%, and 1.79%, respectively. Conclusions SLNB mapping with MBD alone in patients with breast cancer can produce favorable identification rates. The FNR of SLNB decreases as the number of SLNs rises. Because of side effects of searching for additional SLNs and the FNR, removal of three or four SLNs may be appropriate.

scholarly journals Preoperative Tumor Biopsy Results In More Detected Sentinel Nodes Than Intraoperative Biopsy In Breast Cancer Patients

2020 ◽  
Author(s):  
chenxi yuan ◽  
xinzhao wang ◽  
zhaoyun liu ◽  
chao li ◽  
mengxue bian ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
False Negative ◽  
False Negative Rate ◽  
Excisional Biopsy ◽  
Tumor Biopsy ◽  
Tracer Injection ◽  
Sentinel Nodes ◽  
Negative Rate

Abstract Background Sentinel lymph node biopsy (SLNB) acts as a vital role in the breast cancer surgery, and the identified number of sentinel nodes determines its accuracy to represent the status of axillae. There remain two tumor biopsy modes in breast cancer, preoperative and intraoperative biopsy. We compared the effect of the two different biopsies on the result of SLNB. Methods Patients with clinical stage T1-3, N0 tumor were enrolled in this study. 53% received preoperative tumor biopsy and 47% received intraoperative excisional biopsy. For search of the sentinel lymph node, patients received dual tracer injection. The number of SLNs detected and false negative rate were compared between groups. Results 204 patients were enrolled, 108 received preoperative tumor biopsy and 96 received intraoperative excisional biopsy. Among all the patients, 160 received ALND following SLNB. Preoperative tumor biopsy detected more SLNs than intraoperative biopsy (mean rank 113.87 vs. 90.9, p= 0.004). False negative rate in preoperative and intraoperative tumor biopsy was 3% and 18%, respectively. Conclusions Patients in preoperative tumor biopsy group could find more SLNs than intraoperative biopsy patients. False negative rate was also lower in preoperative biopsy group.

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