Application of Contrast Enhanced Ultrasound in Sentinel Lymph Node Biopsy of Breast Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 FUMing-gang ¹ , GUOChen-ming ¹ , GAOJun-xi ²

1. Department of Breast Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China;
2. Department of Ultrasound, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China;

Corresponding author：

FUMing-gang, Email: xjfuminggang@126.com

Keywords：

Breast cancer; Sentinel lymph node; Contrast enhanced ultrasound

DOI：

10.7507/1007-9424.20150115

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the diagnostic value of contrast enhanced ultrasound (CEUS) to the sentinel lymph node (SLN) of breast cancer. Methods Seventy-two operable breast cancer patients with clinically negative axillary lymph node were enrolled.Sulphur hexafluoride microbubbles for injection (SonoVue) was used alone as the tracer agent for the sentinel lymph node biopsy (SLNB), and axillary dissection was performed after the methylene blue location.All SLNs were examined pathologically with HE staining.The SLN diagnosis result of contrast enhanced ultrasound and postoperative pathological examination result were comparative analyzed. Results After the injection of SonoVue can obtain a clear image of the lymphatic vessels and SLN.The success rate of CEUS imaging was 84.72% (61/72) in this group of 72 patients, and the false negative rate was 12.12% (4/33).The sensitivity and specificity of diagnosis by CEUS was 92.50% (37/40) and 92.59% (50/54), respectively, the diagnostic odds ratio (DOR) was 154.17.By the pathology results as the gold standard, the internal consistency of these two methods was good (Kappa value=0.848, P < 0.01). Conclusion CEUS may be a useful orientation and determination method for SLNs.

Citation： FUMing-gang, GUOChen-ming, GAOJun-xi. Application of Contrast Enhanced Ultrasound in Sentinel Lymph Node Biopsy of Breast Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(4): 439-442. doi: 10.7507/1007-9424.20150115 Copy

1.	Demartini WB, Eby PR, Peacock S, et al.Utility of targeted sonography for breast lesions that were suspicious on MRI.AJR Am J Roentgenol, 2009, 192(4):1128-1134.
2.	李学茹, 王文, 杨银学, 等.超声造影实时动态观察猪结肠前哨淋巴结.中国医学影像技术, 2012, 28(4):1945-1948.
3.	Goldberg BB, Merton DA, Liu JB, et al.Sentinel lymph nodes in a swine model with melanoma:contrast-enhanced lymphatic US.Radiology, 2004, 230(3):727-734.
4.	尤厚成, 刘健, 尤楠.超声造影对乳腺良恶性肿块鉴别诊断的价值.中国普外基础与临床杂志, 2011, 18(8):861-865.
5.	严婷, 王文, 李海.超声造影在结直肠癌术中前哨淋巴结显像中的应用研究.中华超声影像杂志, 2013, 11(22):962-964.
6.	Low KS, Littlejohn DR.Optimal number of sentinel nodes after intradermal injection isotope and blue dye.ANZ J Surg, 2006, 76(6):472-475.
7.	李太玉, 孙晓, 王永胜, 等.单用蓝染料示踪剂在乳腺癌前哨淋巴结活检中的价值.中国普外基础与临床杂志, 2010, 17(12):1235-1239.
8.	卢振铎, 刘真真, 杨辉, 等.核素标记法联合亚甲蓝在早期乳腺癌前哨淋巴结活检中的应用价值.肿瘤学杂志, 2012, 18(8):602-604.
9.	Zetterlund L, Stemme S, Arnrup H, et al.Incidence of and risk factors for sentinel lymph node metastasis in patients with a postoperative diagnosis of ductal carcinoma in situ.Br J Surg, 2014, 101(5):488-494.
10.	Ogasawara Y, Doihara H, Shiraiwa M, et al.Multidetector-row computed tomography for the preoperative evaluation of axillary nodal status in patients with breast cancer.Surg Today, 2008, 38(2):104-108.
11.	钟丽瑶, 周平, 李瑞珍, 等.经皮下注射超声造影剂在乳腺癌前哨淋巴结诊断中的价值.中华超声影像学杂志, 2007, 16(9):771-772.
12.	Hill AD, Tran KN, Akhurst T, et al.Lessons learned from 500 cases of lymphatic mapping for breast cancer.Ann Surg, 1999, 229(4):528-535.
13.	Jansen L, Doting MH, Rutgers EJ, et al.Clinical relevance of sentinel lymph nodes outside the axilla in patients with breast cancer.Br J Surg, 2000, 87(7):920-925.
14.	Lee AH, Ellis IO, Pinder SE, et al.Pathological assessment of sentinel lymph-node biopsies in patients with breast cancer.Virchows Arch, 2000, 436(2):97-101.
15.	Mansel RE, Khonji NI, Clarke D.History, present status and future of sentinel node biopsy in breast cancer.The Mary Beves Lecture.Acta Oncol, 2000, 39(3):265-268.
16.	Alconchel Gonzaga SP, Fernández Amigo N, Perozo Limones M, et al.Hypersensitivity reaction after injection of patent blue V dye in saline for sentinal node detection.Rev Esp Anestesiol Reanim, 2010, 57(9):607-609.
17.	Eshima D, Fauconnier T, Eshima L, et al.Radiopharmaceuticals for lymphoscintigraphy:including dosimetry and radiation considerations.Semin Nucl Med, 2000, 30(1):25-32.
18.	Yokota T, Saito T, Narushima Y, et al.Lymph node staining with activated carbon CH40:a new method for axillary lymph node dissection in breast cancer.Can J Surg, 2000, 43(3):191-196.
19.	孙轩, 葛洁, 曹旭晨.纳米炭与美兰在乳腺癌前哨淋巴结活检中的应用.天津医药, 2013, 41(8):828-829.
20.	Buchholz TA, Strom EA, McNeese MD, et al.Radiation therapy as an adjuvant treatment after sentinel lymph node surgery for breast cancer.Surg Clin North Am, 2003, 83(4):911-930.
21.	Kim T, Giuliano AE, Lyman GH.Lymphatic mapping and sentinel lymph node biopsy in early-stage breast carcinoma:a meta analysis.Cancer, 2006, 106(1):4-16.
22.	郑刚, 杨靖, 左文述, 等.中国乳腺癌前哨淋巴结活检验证阶段研究结果的系统评价.中华医学杂志, 2011, 91(6):361-365.
23.	王永胜.乳腺癌前哨淋巴结活检:共识与展望.中国普外基础与临床杂志, 2009, 16(7):505-509.
24.	Terrier C, Tariel O, Coutant C, et al.Comparison of three models to predict non-sentinel lymph node status in breast cancer patients with metastatic sentinel lymph nodes:a retrospective study of 77 patients.J Gynecol Obstet Biol Reprod (Paris), 2012, 41(3):227-234.
25.	Krag D, Weaver D, Ashikaga T, et al.The sentinel node in breast cancer-a multicenter validation study.N Engl J Med, 1998, 339(14):941-946.
26.	Ricci P, Cantisani V, Ballesio L, et al.Benign and malignant breast lesions:efficacy of real time contrastĉenhanced ultrasound vs.magnetic resonance imaging.Ultraschall Med, 2007, 28(1):57-62.
27.	Jung EM, Jungius KP, Rupp N, et al.Contrast enhanced harmonic ultrasound for differentiating breast tumors-first results.Clin Hemorheol Microcirc, 2005, 33(2):109-120.

1. Demartini WB, Eby PR, Peacock S, et al.Utility of targeted sonography for breast lesions that were suspicious on MRI.AJR Am J Roentgenol, 2009, 192(4):1128-1134.
2. 李学茹, 王文, 杨银学, 等.超声造影实时动态观察猪结肠前哨淋巴结.中国医学影像技术, 2012, 28(4):1945-1948.
3. Goldberg BB, Merton DA, Liu JB, et al.Sentinel lymph nodes in a swine model with melanoma:contrast-enhanced lymphatic US.Radiology, 2004, 230(3):727-734.
4. 尤厚成, 刘健, 尤楠.超声造影对乳腺良恶性肿块鉴别诊断的价值.中国普外基础与临床杂志, 2011, 18(8):861-865.
5. 严婷, 王文, 李海.超声造影在结直肠癌术中前哨淋巴结显像中的应用研究.中华超声影像杂志, 2013, 11(22):962-964.
6. Low KS, Littlejohn DR.Optimal number of sentinel nodes after intradermal injection isotope and blue dye.ANZ J Surg, 2006, 76(6):472-475.
7. 李太玉, 孙晓, 王永胜, 等.单用蓝染料示踪剂在乳腺癌前哨淋巴结活检中的价值.中国普外基础与临床杂志, 2010, 17(12):1235-1239.
8. 卢振铎, 刘真真, 杨辉, 等.核素标记法联合亚甲蓝在早期乳腺癌前哨淋巴结活检中的应用价值.肿瘤学杂志, 2012, 18(8):602-604.
9. Zetterlund L, Stemme S, Arnrup H, et al.Incidence of and risk factors for sentinel lymph node metastasis in patients with a postoperative diagnosis of ductal carcinoma in situ.Br J Surg, 2014, 101(5):488-494.
10. Ogasawara Y, Doihara H, Shiraiwa M, et al.Multidetector-row computed tomography for the preoperative evaluation of axillary nodal status in patients with breast cancer.Surg Today, 2008, 38(2):104-108.
11. 钟丽瑶, 周平, 李瑞珍, 等.经皮下注射超声造影剂在乳腺癌前哨淋巴结诊断中的价值.中华超声影像学杂志, 2007, 16(9):771-772.
12. Hill AD, Tran KN, Akhurst T, et al.Lessons learned from 500 cases of lymphatic mapping for breast cancer.Ann Surg, 1999, 229(4):528-535.
13. Jansen L, Doting MH, Rutgers EJ, et al.Clinical relevance of sentinel lymph nodes outside the axilla in patients with breast cancer.Br J Surg, 2000, 87(7):920-925.
14. Lee AH, Ellis IO, Pinder SE, et al.Pathological assessment of sentinel lymph-node biopsies in patients with breast cancer.Virchows Arch, 2000, 436(2):97-101.
15. Mansel RE, Khonji NI, Clarke D.History, present status and future of sentinel node biopsy in breast cancer.The Mary Beves Lecture.Acta Oncol, 2000, 39(3):265-268.
16. Alconchel Gonzaga SP, Fernández Amigo N, Perozo Limones M, et al.Hypersensitivity reaction after injection of patent blue V dye in saline for sentinal node detection.Rev Esp Anestesiol Reanim, 2010, 57(9):607-609.
17. Eshima D, Fauconnier T, Eshima L, et al.Radiopharmaceuticals for lymphoscintigraphy:including dosimetry and radiation considerations.Semin Nucl Med, 2000, 30(1):25-32.
18. Yokota T, Saito T, Narushima Y, et al.Lymph node staining with activated carbon CH40:a new method for axillary lymph node dissection in breast cancer.Can J Surg, 2000, 43(3):191-196.
19. 孙轩, 葛洁, 曹旭晨.纳米炭与美兰在乳腺癌前哨淋巴结活检中的应用.天津医药, 2013, 41(8):828-829.
20. Buchholz TA, Strom EA, McNeese MD, et al.Radiation therapy as an adjuvant treatment after sentinel lymph node surgery for breast cancer.Surg Clin North Am, 2003, 83(4):911-930.
21. Kim T, Giuliano AE, Lyman GH.Lymphatic mapping and sentinel lymph node biopsy in early-stage breast carcinoma:a meta analysis.Cancer, 2006, 106(1):4-16.
22. 郑刚, 杨靖, 左文述, 等.中国乳腺癌前哨淋巴结活检验证阶段研究结果的系统评价.中华医学杂志, 2011, 91(6):361-365.
23. 王永胜.乳腺癌前哨淋巴结活检:共识与展望.中国普外基础与临床杂志, 2009, 16(7):505-509.
24. Terrier C, Tariel O, Coutant C, et al.Comparison of three models to predict non-sentinel lymph node status in breast cancer patients with metastatic sentinel lymph nodes:a retrospective study of 77 patients.J Gynecol Obstet Biol Reprod (Paris), 2012, 41(3):227-234.
25. Krag D, Weaver D, Ashikaga T, et al.The sentinel node in breast cancer-a multicenter validation study.N Engl J Med, 1998, 339(14):941-946.
26. Ricci P, Cantisani V, Ballesio L, et al.Benign and malignant breast lesions:efficacy of real time contrastĉenhanced ultrasound vs.magnetic resonance imaging.Ultraschall Med, 2007, 28(1):57-62.
27. Jung EM, Jungius KP, Rupp N, et al.Contrast enhanced harmonic ultrasound for differentiating breast tumors-first results.Clin Hemorheol Microcirc, 2005, 33(2):109-120.

Previous Article
肝圆韧带坏死1例报道
Next Article
Medical Glue and Stapling Fixed False Hernia Sac for Preventing Postoperative Seroma in Patients with Direct Hernia

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of Contrast Enhanced Ultrasound in Sentinel Lymph Node Biopsy of Breast Cancer

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content