Abstract
The objective of the work described here was to evaluate the efficacy of lymphosonography
in identifying sentinel lymph nodes (SLNs) in patients with breast cancer undergoing
surgical excision. Of the 86 individuals enrolled, 79 completed this institutional
review board–approved study. Participants received subcutaneous 1.0-mL injections
of ultrasound contrast agent (UCA) around the tumor. An ultrasound scanner with contrast-enhanced
ultrasound (CEUS) capabilities was used to identify SLNs. Participants were administered
with blue dye and radioactive tracer to guide SLN excision as standard-of-care. Excised
SLNs were classified as positive or negative for the presence of blue dye, radioactive
tracer and UCA, and sent for pathology. Two hundred fifty-two SLNs were excised; 158
were positive for blue dye, 222 were positive for radioactive tracer and 223 were
positive for UCA. Comparison with blue dye revealed accuracies of 96.2% for radioactive
tracer and 99.4% for lymphosonography (p > 0.15). Relative to radioactive tracer, blue dye had an accuracy of 68.5%, and lymphosonography
achieved 86.5% (p < 0.0001). Of 252 SLNs excised, 34 were determined to be malignant by pathology;
18 were positive for blue dye (detection rate = 53%), 23 for radioactive tracer (detection
rate = 68%) and 34 for UCA (detection rate = 100%) (p < 0.0001). Lymphosonography was similar in accuracy to radioactive tracer and higher
in accuracy than blue dye in identifying SLNs. All 34 malignant SLNs were identified
by lymphosonography.
Key Words
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Article info
Publication history
Published online: November 26, 2022
Accepted:
October 30,
2022
Received in revised form:
September 27,
2022
Received:
June 8,
2022
Identification
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