A team led by Dr. Basak Dogan from University of Texas Southwestern Medical Center included 21 patients with newly diagnosed early-stage invasive breast cancer in the study. All the women had regular ultrasound scans before surgery, and all underwent microbubble contrast ultrasound to evaluate the axilla; CEUS-identified nodes were biopsied with fine-needle aspiration and treated with localized radioactive seeds. The women also underwent sentinel lymph node biopsy using technetium-99m. Dogan's group then compared preoperative fine-needle aspiration results and final pathological assessment of the node.
As a technique, CEUS worked in 20 of the 21 patients, and all biopsied and localized nodes that were identified were correlated with sentinel lymph nodes identified surgically. In 90% of patients, the nodes identified by CEUS correlated with the sentinel lymph node that reacted the most to the technetium-99m. Two patients had metastases in a single lymph node; one of these metastases was identified before surgery by CEUS-guided fine-needle aspiration biopsy.
None of the women experienced significant side effects in the immediate period following these procedures or after 30 days, leading the researchers to conclude that CEUS-guided sentinel lymph node biopsy shows promise as an alternative to surgical lymph node staging.
