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Sentinel Lymph Node Mapping and Biopsy for Endometrial Cancer at Early Stage with Laparoscopy
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Sentinel Lymph Node Identification in Post Neoadjuvant Chemotherapy Breast Cancer Patients Undergoing Surgical

Priscilla Machado1, Ji-Bin Liu1, Laurence Needleman1

  • 1Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine
|January 2, 2023
PubMed
Summary

Lymphosonography effectively identifies sentinel lymph nodes (SLNs) in breast cancer patients post-chemotherapy. This imaging technique achieved 100% detection of malignant SLNs, outperforming traditional methods.

Keywords:
breast cancercontrast-enhanced ultrasoundlymph nodelymphatic tracerneoadjuvant chemotherapy

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Area of Science:

  • Oncology
  • Radiology
  • Surgical Pathology

Background:

  • Accurate sentinel lymph node (SLN) identification is crucial for breast cancer staging and treatment planning.
  • Neoadjuvant chemotherapy can alter lymphatic drainage, potentially impacting SLN detection rates.
  • Evaluating novel imaging modalities for SLN identification in this patient population is essential.

Purpose of the Study:

  • To assess the efficacy of lymphosonography in identifying SLNs in breast cancer patients who have received neoadjuvant chemotherapy.
  • To compare the diagnostic accuracy of lymphosonography with standard methods (blue dye and radioactive tracer) for SLN detection.

Main Methods:

  • Seventy-nine breast cancer patients scheduled for SLN excision were included.
  • Eighteen patients (23%) received neoadjuvant chemotherapy prior to surgery.
  • Lymphosonography was performed using Sonazoid contrast agent, with results compared to blue dye, radioactive tracer, and final pathology.

Main Results:

  • Lymphosonography demonstrated a 67% accuracy in identifying SLNs compared to radioactive tracer (53%) and blue dye (53%).
  • The detection rate for malignant SLNs was 100% with lymphosonography, versus 67% for radioactive tracer and 47% for blue dye.
  • All 15 pathologically confirmed malignant SLNs were identified by lymphosonography.

Conclusions:

  • Lymphosonography is a highly accurate method for identifying sentinel lymph nodes in breast cancer patients post-neoadjuvant chemotherapy.
  • This technique offers superior detection rates for malignant SLNs compared to conventional blue dye and radioactive tracer methods.
  • Lymphosonography represents a promising advancement in SLN mapping for oncologic surgery.