Affiliations: [a] Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| [b] Department of Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
Correspondence:
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Corresponding author: Xian-Quan Shi, Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Beijing, China 100050. Tel.: +010 80838576; Fax: +010 80838049; E-mail: sonoshixq@ccmu.edu.cn.
Abstract: 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.
Keywords: Contrast-enhanced ultrasound, sentinel lymph node, fine-needle aspiration cytology, breast cancer
