title: Ultrasound-guided lymph node sampling in the initial management of breast cancer.
abstract: Ultrasound-guided fine needle sampling is proving very useful for avoiding surgical biopsy of the sentinel lymph node for N+breast cancer. Because of its high specificity, cytology is sufficient in most cases. Focal or diffuse cortical thickening or the absence of the echogenic hilum irrespective of the size and shape of the lymph node are ultrasound signs which should be taken into account. The status of the lymph nodes in axillary and extra-axillary sites has an impact on the later management of patients and reduces the length of time for secondary lymph node dissection and adjuvant therapy, as one third of sentinel ganglion procedures can be avoided. It should be possible to optimise identification of the sentinel lymph node by the intradermal injection of ultrasound contrast agent. The cost/effectiveness ratio is positive but unknown and should be assessed in the initial management of breast cancer.
authors.affiliation: Department of radiology, centre Antoine-Lacassagne, 33 avenue de Valombrose, Nice cedex 2, France. balu-maestro.catherine@nice.unicancer.fr
authors.forename: C
authors.initials: C
authors.lastname: Balu-Maestro
authors.forename: A
authors.initials: A
authors.lastname: Ianessi
authors.forename: C
authors.initials: C
authors.lastname: Chapellier
authors.forename: C
authors.initials: C
authors.lastname: Marcotte
authors.forename: S
authors.initials: S
authors.lastname: Stolear
mesh_terms: D044963:Biopsy, Fine-Needle / Q000379:methods; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging / Q000473:pathology; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D018084:Ultrasonography, Interventional / Q000379:methods*; D016217:Ultrasonography, Mammary / Q000379:methods