Article ; Online: Contrast-enhanced Ultrasound Using Intradermal Microbubble Sulfur Hexafluoride in Non-invasive Axillary Staging in Breast Cancer: Are we Missing a Chance?
2024 Volume 44, Issue 5, Page(s) 2021–2030
Abstract: Background/aim: In the context of surgical de-escalation in early breast cancer (EBC), this study aimed to evaluate the contrast enhancement ultrasound (CEUS) sentinel lymph node (SLN) procedure as a non-invasive axillary staging procedure in EBC in ... ...
| Abstract | Background/aim: In the context of surgical de-escalation in early breast cancer (EBC), this study aimed to evaluate the contrast enhancement ultrasound (CEUS) sentinel lymph node (SLN) procedure as a non-invasive axillary staging procedure in EBC in comparison with standard SLN biopsy (SLNB). Patients and methods: A subanalysis of the AX-CES study, a prospective single-arm, monocentric phase 3 study was performed (EudraCT: 2020-000393-20). The study included patients with EBC undergoing upfront surgery and SLN resection, with no prior history of locoregional treatment, and weighing between 40-85 kg. All patients underwent the CEUS SLN procedure as a non-invasive axillary staging procedure, with CEUS SLN accumulation marked using blue dye. After the CEUS SLN procedure, all patients underwent the standard mapping procedure. Data on success rate, systemic reactions, mean procedure time, mean surgical procedure, mean procedure without axillary staging, CEUS SLN appearance (normal/pathological), SLN number, and concordance with standard mapping procedure were collected. Results: After the CEUS SLN procedure, 29 LNs among 16 patients were identified and marked. In all cases, CEUS SLN revealed at least one LN enhancement. Six (37.50%) LNs were defined as pathological after the CEUS SLN procedure. Definitive staining of CEUS SLN pathology revealed metastatic involvement in four (66.67%) of the cases. Two SLNs were identified during the CEUS SLN procedure; however, owing to the low disease burden, no change in the surgical plan was reported. Conclusion: The CEUS SLN procedure shows promise as a technique for non-invasive assessment of the axilla, potentially enabling safe axillary de-escalation in EBC by estimating the axillary disease burden. |
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| MeSH term(s) | Humans ; Breast Neoplasms/pathology ; Breast Neoplasms/diagnostic imaging ; Breast Neoplasms/surgery ; Female ; Contrast Media/administration & dosage ; Axilla ; Neoplasm Staging ; Middle Aged ; Aged ; Prospective Studies ; Sentinel Lymph Node Biopsy/methods ; Sulfur Hexafluoride/administration & dosage ; Ultrasonography/methods ; Microbubbles ; Lymphatic Metastasis/diagnostic imaging ; Sentinel Lymph Node/pathology ; Sentinel Lymph Node/diagnostic imaging ; Sentinel Lymph Node/surgery ; Adult |
| Chemical Substances | Contrast Media ; Sulfur Hexafluoride (WS7LR3I1D6) |
| Language | English |
| Publishing date | 2024-04-25 |
| Publishing country | Greece |
| Document type | Journal Article ; Clinical Trial, Phase III |
| ZDB-ID | 604549-2 |
| ISSN | 1791-7530 ; 0250-7005 |
| ISSN (online) | 1791-7530 |
| ISSN | 0250-7005 |
| DOI | 10.21873/anticanres.17005 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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