Preliminary Study of Contrast-enhanced Ultrasound in Combination with Blue Dye Vs. Indocyanine Green Fluorescence, in Combination with Blue Dye for Sentinel Lymph Node Biopsy in Breast Cancer

Overview

Journal BMC Cancer

Publisher Biomed Central

Specialty Oncology

Date 2019 Oct 13

PMID 31604469

Citations 9

Authors

Yidong Zhou

Yan Li

Feng Mao

Jing Zhang

Qingli Zhu

Songjie Shen

Yan Lin

Xiaohui Zhang

He Liu

Mengsu Xiao

Yuxin Jiang

Qiang Sun

Affiliations

Soon will be listed here.

Abstract

Background: This preliminary study aimed to examine the feasibility of sentinel lymph node biopsy (SLNB) using contrast-enhanced ultrasound (CEUS) vs. indocyanine green fluorescence (ICG), combined with blue dye in patients with breast cancer.

Methods: This was a retrospective study of consecutive female patients with invasive stage I-III (based on pre-operative physical examination and imaging) primary breast cancer at the Peking Union Medical College Hospital between 01/2013 and 01/2015 who underwent preoperative SLNB by ICG + blue dye or CEUS + blue dye. The numbers of detected SLNs, detection rates, and recurrence-free survival (RFS) rates were compared between the two groups.

Results: A total of 443 patients were included. The detection rates of SLNs in the CEUS + blue dye and ICG + blue dye groups were 98.4 and 98.1%, respectively (P = 0.814). The average numbers of SLNs detected per patient showed no significant difference between the two groups (3.06 ± 1.33 and 3.12 ± 1.31 in the CEUS + blue dye and ICG + blue dye groups, respectively; P = 0.659). After a median follow-up of 46 months, five patients in the CEUS + blue dye group and 15 in the ICG + blue dye group had recurrence. RFS rates showed no significant difference (P = 0.55).

Conclusion: This preliminary study suggests that CEUS + blue dye and ICG + blue dye are both feasible for SLN detection in breast cancer.

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References

Sugie T, Sawada T, Tagaya N, Kinoshita T, Yamagami K, Suwa H . Comparison of the indocyanine green fluorescence and blue dye methods in detection of sentinel lymph nodes in early-stage breast cancer. Ann Surg Oncol. 2013; 20(7):2213-8. DOI: 10.1245/s10434-013-2890-0. View

Mattrey R, Kono Y, Baker K, Peterson T . Sentinel lymph node imaging with microbubble ultrasound contrast material. Acad Radiol. 2002; 9 Suppl 1:S231-5. DOI: 10.1016/s1076-6332(03)80444-0. View

Pepels M, de Boer M, Bult P, van Dijck J, van Deurzen C, Menke-Pluymers M . Regional recurrence in breast cancer patients with sentinel node micrometastases and isolated tumor cells. Ann Surg. 2011; 255(1):116-21. DOI: 10.1097/SLA.0b013e31823dc616. View

Cox K, Sever A, Jones S, Weeks J, Mills P, Devalia H . Validation of a technique using microbubbles and contrast enhanced ultrasound (CEUS) to biopsy sentinel lymph nodes (SLN) in pre-operative breast cancer patients with a normal grey-scale axillary ultrasound. Eur J Surg Oncol. 2013; 39(7):760-5. DOI: 10.1016/j.ejso.2013.03.026. View

Sever A, Mills P, Jones S, Cox K, Weeks J, Fish D . Preoperative sentinel node identification with ultrasound using microbubbles in patients with breast cancer. AJR Am J Roentgenol. 2011; 196(2):251-6. DOI: 10.2214/AJR.10.4865. View

Ahmed M, Purushotham A, Douek M . Novel techniques for sentinel lymph node biopsy in breast cancer: a systematic review. Lancet Oncol. 2014; 15(8):e351-62. DOI: 10.1016/S1470-2045(13)70590-4. View

Saad E, Squifflet P, Burzykowski T, Quinaux E, Delaloge S, Mavroudis D . Disease-free survival as a surrogate for overall survival in patients with HER2-positive, early breast cancer in trials of adjuvant trastuzumab for up to 1 year: a systematic review and meta-analysis. Lancet Oncol. 2019; 20(3):361-370. PMC: 7050571. DOI: 10.1016/S1470-2045(18)30750-2. View

Cui X, Ignee A, Nielsen M, Schreiber-Dietrich D, De Molo C, Pirri C . Contrast enhanced ultrasound of sentinel lymph nodes. J Ultrason. 2015; 13(52):73-81. PMC: 4613570. DOI: 10.15557/JoU.2013.0006. View

Goldberg B, Merton D, Liu J, Thakur M, Murphy G, Needleman L . Sentinel lymph nodes in a swine model with melanoma: contrast-enhanced lymphatic US. Radiology. 2004; 230(3):727-34. DOI: 10.1148/radiol.2303021440. View

10.

Xie F, Zhang D, Cheng L, Yu L, Yang L, Tong F . Intradermal microbubbles and contrast-enhanced ultrasound (CEUS) is a feasible approach for sentinel lymph node identification in early-stage breast cancer. World J Surg Oncol. 2015; 13:319. PMC: 4653941. DOI: 10.1186/s12957-015-0736-x. View

11.

Aoyama K, Kamio T, Ohchi T, Nishizawa M, Kameoka S . Sentinel lymph node biopsy for breast cancer patients using fluorescence navigation with indocyanine green. World J Surg Oncol. 2011; 9:157. PMC: 3269998. DOI: 10.1186/1477-7819-9-157. View

12.

Degnim A, Zakaria S, Boughey J, Sookhan N, Reynolds C, Donohue J . Axillary recurrence in breast cancer patients with isolated tumor cells in the sentinel lymph node [AJCC N0(i+)]. Ann Surg Oncol. 2010; 17(10):2685-9. DOI: 10.1245/s10434-010-1062-8. View

13.

Sugie T, Ikeda T, Kawaguchi A, Shimizu A, Toi M . Sentinel lymph node biopsy using indocyanine green fluorescence in early-stage breast cancer: a meta-analysis. Int J Clin Oncol. 2016; 22(1):11-17. DOI: 10.1007/s10147-016-1064-z. View

14.

Esfehani M, Yazdankhah-Kenari A, Omranipour R, Mahmoudzadeh H, Shahriaran S, Zafarghandi M . Validation of Contrast Enhanced Ultrasound Technique to Wire Localization of Sentinel Lymph Node in Patients with Early Breast Cancer. Indian J Surg Oncol. 2016; 6(4):370-3. PMC: 4809854. DOI: 10.1007/s13193-015-0446-4. View

15.

Hung W, Chan C, Ying M, Chong S, Mak K, Yip A . Randomized clinical trial comparing blue dye with combined dye and isotope for sentinel lymph node biopsy in breast cancer. Br J Surg. 2005; 92(12):1494-7. DOI: 10.1002/bjs.5211. View

16.

van der Vorst J, Schaafsma B, Verbeek F, Hutteman M, Mieog J, Lowik C . Randomized comparison of near-infrared fluorescence imaging using indocyanine green and 99(m) technetium with or without patent blue for the sentinel lymph node procedure in breast cancer patients. Ann Surg Oncol. 2012; 19(13):4104-11. PMC: 3465510. DOI: 10.1245/s10434-012-2466-4. View

17.

Hojo T, Nagao T, Kikuyama M, Akashi S, Kinoshita T . Evaluation of sentinel node biopsy by combined fluorescent and dye method and lymph flow for breast cancer. Breast. 2010; 19(3):210-3. DOI: 10.1016/j.breast.2010.01.014. View

18.

Kataria K, Srivastava A, Qaiser D . What Is a False Negative Sentinel Node Biopsy: Definition, Reasons and Ways to Minimize It?. Indian J Surg. 2016; 78(5):396-401. PMC: 5127992. DOI: 10.1007/s12262-016-1531-9. View

19.

Benson J . Indocyanine Green Fluorescence for Sentinel Lymph Node Detection in Early Breast Cancer. Ann Surg Oncol. 2015; 23(1):6-8. DOI: 10.1245/s10434-015-4801-z. View

20.

Liu J, Huang L, Wang N, Chen P . Indocyanine green detects sentinel lymph nodes in early breast cancer. J Int Med Res. 2017; 45(2):514-524. PMC: 5536661. DOI: 10.1177/0300060516687149. View