Hookwire-guided Sentinel Lymph Node Biopsy Using Contrast-enhanced Ultrasonography Followed by a One-step Nucleic Acid Amplification (OSNA) Assay for Breast Cancer
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Updated: Jan 4, 2026
The Application of 1% Methylene Blue Dye As a Single Technique in Breast Cancer Sentinel Node Biopsy
Published on: June 1, 2019
Tomohiro Miyake1, Kenzo Shimazu2, Tomonori Tanei1
1Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Aim:
To investigate the feasibility of hookwire-guided sentinel lymph node biopsy (SLNB) using contrast-enhanced ultrasonography (CEUS) followed by a one-step nucleic acid amplification (OSNA) assay.
Patients And Methods:
Clinical T1-2N0M0 breast cancer patients scheduled to undergo SLNB participated in this study. Both Sonazoid® and dye were used as tracers, and the most upstream sentinel lymph node (SLN) at each lymphatic flow detected by CEUS (First-SLN) was sampled under hookwire guidance, a procedure called "Sona-Hook".
Results:
In each of the 50 cases, at least one First-SLN was extracted by "Sona-Hook". All contrast-enhanced SLNs (CE-SLNs) were dye-positive, and the mean number of CE-SLNs sampled per patient was lower than that of dye-positive SLNs (1.48 vs. 1.88, p<0.01). Through OSNA, qualitative assessment of tumor metastasis between First-SLNs and all SLNs completely matched together.
Conclusion:
"Sona-Hook" for First-SLN followed by an OSNA assay may be a feasible minimally invasive SLNB strategy.
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