Enhanced pre-operative axillary staging using intradermal microbubbles and contrast-enhanced ultrasound to detect and biopsy sentinel lymph nodes in breast cancer: a potential replacement for axillary surgery
| Autor: | Matthew G. Wallis, Philippa Mills, Nisha Sharma, Meng-Xing Tang, Karina Cox, Keshthra Satchithananda, Jennifer Weeks, Mohamed Hashem, Ali Sever, Adrian Lim, Isobel Haigh, Tania de Silva, Sian Taylor-Phillips |
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| Přispěvatelé: | Taylor-Phillips, Sian [0000-0002-1841-4346], Apollo - University of Cambridge Repository |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
medicine.medical_specialty Biopsy Sentinel lymph node Contrast Media Breast Neoplasms Sensitivity and Specificity Preoperative care 030218 nuclear medicine & medical imaging RC0254 03 medical and health sciences 0302 clinical medicine Breast cancer Preoperative Care medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Prospective cohort study Aged Retrospective Studies Neoplasm Staging Aged 80 and over Microbubbles medicine.diagnostic_test Full Paper business.industry Sentinel Lymph Node Biopsy Retrospective cohort study General Medicine Middle Aged medicine.disease Surgery Axilla medicine.anatomical_structure Lymphatic Metastasis 030220 oncology & carcinogenesis Lymph Node Excision Female Ultrasonography Mammary Radiology Lymph Nodes Sentinel Lymph Node business Contrast-enhanced ultrasound |
| ISSN: | 0007-1285 |
| Popis: | OBJECTIVE: To compare the experience of four UK Centres in the use of intradermal microbubbles and contrast enhanced ultrasound (CEUS) to pre-operatively identify and biopsy sentinel lymph nodes (SLN) in patients with breast cancer. METHODS: In all centres, breast cancer patients had a microbubble/CEUS SLN core biopsy prior to axillary surgery and patients in Centres 1 and 2 had a normal greyscale axillary ultrasound. Data were collected between 2010 and 2016; 1361 from Centre 1 (prospective, sequential), 376 from Centre 2 (retrospective, sequential), 121 from Centre 3 (retrospective, selected) and 48 from Centre 4 (prospective, selected). RESULTS: SLN were successfully core biopsied in 80% (Centre 1), 79.6% (Centre 2), 77.5% (Centre 3) and 88% (Centre 4). The sensitivities to identify all SLN metastases were 46.9% [95% confidence intervals (CI) (39.4-55.1)], 52.5% [95% CI (39.1-65.7)], 46.4% [95% CI (27.5-66.1)] and 45.5% [95% CI (16.7-76.6)], respectively. The specificities were 99.7% [95% CI (I98.9-100)], 98.1% [95% CI (94.5-99.6)], 100% [95% CI (93.2-100%)] and 96.3% [95% CI (81-99.9)], respectively.The negative predictive values were 87.0% [95% CI (84.3-89.3)], 84.5% [95% CI (78.4-89.5)], 86.9% [95% CI (82.4-90.3)] and 86.2% [95% CI (78.4-91.5)], respectively. At Centres 1 and 2, 12/730 (1.6%) and 7/181 (4%), respectively, of patients with a benign microbubble/CEUS SLN core biopsy had two or more lymph node (LN) macrometastases found at the end of primary surgical treatment. CONCLUSION: The identification and biopsy of SLN using CEUS is a reproducible technique. Advances in knowledge: In the era of axillary conservation, microbubble/CEUS SLN core biopsy has the potential to succeed surgical staging of the axilla. |
| Databáze: | OpenAIRE |
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