Sentinel node detection in breast cancer using contrast-enhanced sonography with 25% albumin--Initial clinical experience.
OBJECTIVE
To determine the clinical usefulness of a sentinel lymph node (SLN) identification technique using contrast-enhanced sonography (CEUS) with 25% albumin.


METHODS
The subjects were 23 women with breast cancer. Each was injected subcutaneously with 5 ml of 25% albumin solution as a negative contrast agent directly superficial to the breast tumor. The area was massaged, and the inferior axillary hairline was examined continuously using gray-scale sonography with a 7.5- or 10-MHz transducer. Any contrast-enhanced lymph node was considered a CEUS-detected SLN, was differentiated from other level I and II nodes, and was resected and pathologically assessed.


RESULTS
In all 23 patients, 1 or 2 CEUS-detected SLNs (mean, 1.3 SLNs) were identified. Their sizes ranged from 5 mm to 25 mm (mean, 11.3 mm), and their depths (from the skin surface) ranged from 5mm to 20 mm (mean, 12.6 mm). Pathologic examination revealed a metastasis in 5 of the 23 patients, all in CEUS-detected SLNs.


CONCLUSIONS
In a clinical study using CEUS with 25% albumin, contrast-enhanced nodes were identified in all subjects. The pathologic findings suggested that any metastatic nodes observed were SLNs, indicating that this technique may represent a new modality for SLN identification.
Omoto
Kiyoka
K
Department of Clinical Laboratory Medicine, Jichi Medical University, Yakushiji 3311-1, Shimotsuke-city , Tochigi-pref, 329-0498, Japan.
Hozumi
Yasuo
Y
Omoto
Yawara
Y
Taniguchi
Nobuyuki
N
Itoh
Kouichi
K
Fujii
Yasutomo
Y
Mizunuma
Hirobumi
H
Nagai
Hideo
H
D000328:Adult; D000368:Aged; D000418:Albumins; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis; D008875:Middle Aged; D014463:Ultrasonography
D000418:Albumins; D003287:Contrast Media