Fujian Provincial Cancer Hospital, Fuzhou, China
Xiufeng Wu , Lina Tang , Yi Zeng , Xia Chen
Background: The aim of this prospective study was to evaluate the feasibility of contrast-enhanced ultrasonography (CEUS) for the identification of sentinel lymph node (SLN) in breast cancer patients with cN0 following neoadjuvant chemotherapy (NAC). Methods: Patients with cN0 following NAC (n=66) received a periareolar injection of SonoVue followed by ultrasound (US) to identify contrast-enhanced SLN before surgery. All patients underwent axillary lymph node dissection for verification of axillary node status after the SLN biopsy. The identification rate, sensitivity, specificity, accuracy, false negative rate, negative predictive value, positive predictive value was recorded. Results: In almost all cases, the SLNs were easily identified with an identification rate of 98.5 % (65/66). Compared with pathological diagnosis, sensitivity, specificity, accuracy, and false negative rate of CEUS for SLN diagnosis were 66.7%, 95.8%, 78.8%, and 14.3% respectively. Conclusions: Identification of SLN by CEUS is a technically feasible method with an identification rate as high as 98.5%.
Characteristics | Number of patients (N=66) (%) |
---|---|
Age | |
<50 | 43(65.2%) |
>50 | 23(34.8%) |
Tumor size | |
<2cm | 18(27.3%) |
>2cm | 45(68.2%) |
Tx | 3 (4.5%) |
Grade | |
I | 10(15.2%) |
II | 22(33.3%) |
III | 34(51.5%) |
Tumor histology | |
IDC | 50(75.8%) |
ILC | 16(24.2%) |
Estrogen receptor status | |
Positive | 16(24.2%) |
Negative | 50(75.8%) |
HER2 status | |
Positive | 42(63.6%) |
Negative | 24(36.4%) |
SLN status using CEUS | |||||
---|---|---|---|---|---|
ALND | Total | ||||
Positive | Negative | ||||
Positive | 12 | 2 | 14 | PPV=85.7% (12/14) | |
Negative | 6 | 46 | 52 | NPV=88.5% (45/52) | |
Total | 18 | 48 | 66 | FNR=14.3% (2/14) | |
Sens=66.7% (12/18) | Spec=95.8% (46/48) | Accuracy=78.8%(52/66) |
Sens: Sensitivity; Spec: Specificity; PPV: Positive predictive value; NPV: Negative predictive value. FNR: False negative rate.
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