Identification of the Sentinel Node by Ultrasonography in Patients with Breast Cancer

Abstract

Using an iron preparation, the SN in patients with breast cancer can be identified with US with an accuracy equal to and perhaps better than that achieved with a radioactive tracer. These findings may change the current diagnostic model and affect the therapeutic algorithm of breast cancer patients.

Preoperative ultrasound staging of the axilla make’s peroperative examination of the sentinel node redundant in breast cancer: saving tissue, time and money

“…Furthermore new randomized controlled trials (SOUND: Sentinel node versus observation after axillary ultrasound and INSEMA: Intergroup Sentinel Mamma) are being conducted to explore the possibility of omitting SLN biopsy in selected patients with a negative axillary ultrasound and consequently low axillary burden [41,42] and new diagnostic tools to identify metastatic sentinel nodes preoperatively are being developed. These methods based on computed tomography-lymphography [43] or US with iron markers [44] have the same high accuracy as radio-isotopes. Lastly, preoperative staging remains an important diagnostic tool in the setting of neoadjuvant therapy and can be helpful in making and deciding the type and timing of breast reconstruction since the presence of axillary metastases influences the need for postmastectomy radiation [22] After the publication of the Z0011 trial results there is a big discussion about the role of preoperative axillary staging.…”

Comparison between Ultrasound and Pathologic Status of Axillary Lymph Nodes in Clinically Node-negative Breast Cancer Patients

“…13 Another area of developing study is the use of novel adjuncts to aid in the identification of the sentinel node via US in the clinically negative axilla. In a proof on concept published by Kusminsky et al, 14 the authors used a novel iron salt injected peritumorally into the breast to identify the sentinel lymph node via US as opposed to the use of a radionucelide/gamma probe technique preparation. The iron preparation, which was visible on US, diffused into the regional nodal basin and permitted identification of the sentinel node using US alone.…”