title: Accurate evaluation of axillary sentinel lymph node metastasis using contrast-enhanced ultrasonography with Sonazoid in breast cancer: a preliminary clinical trial.
abstract: Breast cancer is the most common type of cancer in women. The 5-year survival rate in patients with breast cancer ranges from 74 to 82 %. Sentinel lymph node biopsy has become an alternative to axillary lymph node dissection for nodal staging. We evaluated the detection of the sentinel lymph node and metastasis of the lymph node using contrast enhanced ultrasonography with Sonazoid. Between December 2013 and May 2014, 32 patients with operable breast cancer were enrolled in this study. We evaluated the detection of axillary sentinel lymph nodes and the evaluation of axillary lymph nodes metastasis using contrast enhanced computed tomography, color Doppler ultrasonography and contrast enhanced ultrasonography with Sonazoid. All the sentinel lymph nodes were identified, and the sentinel lymph nodes detected by contrast enhanced ultrasonography with Sonazoid corresponded with those detected by computed tomography lymphography and indigo carmine method. The detection of metastasis based on contrast enhanced computed tomography were sensitivity 20.0 %, specificity 88.2 %, PPV 60.0 %, NPV 55.6 %, accuracy 56.3 %. Based on color Doppler ultrasonography, the results were sensitivity 36.4 %, specificity 95.2 %, PPV 80.0 %, NPV 74.1 %, accuracy 75.0 %. Based on contrast enhanced ultrasonography with Sonazoid, the results were sensitivity 81.8 %, specificity 95.2 %, PPV 90.0 %, NPV 90.9 %, accuracy 90.6 %. The results suggested that contrast enhanced ultrasonography with Sonazoid was the most accurate among the evaluations of these modalities. In the future, we believe that our method would take the place of conventional sentinel lymph node biopsy for an axillary staging method.
authors.affiliation: Department of Surgery, Hokkaido Social Work Association Obihiro Hospital, 2 East 5 South 9, Obihiro, Hokkaido 080-0805 Japan ; Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-Ku, Sapporo, Hokkaido 060-8638 Japan.
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Matsuzawa
authors.affiliation: Diagnostic Ultrasound Division, Department of Laboratory Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503 Japan.
authors.forename: Kiyoka
authors.initials: K
authors.lastname: Omoto
authors.affiliation: Department of Surgery, Hokkaido Social Work Association Obihiro Hospital, 2 East 5 South 9, Obihiro, Hokkaido 080-0805 Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Einama
authors.affiliation: Department of Surgery, Hokkaido Social Work Association Obihiro Hospital, 2 East 5 South 9, Obihiro, Hokkaido 080-0805 Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Abe
authors.affiliation: Department of Surgery, Hokkaido Social Work Association Obihiro Hospital, 2 East 5 South 9, Obihiro, Hokkaido 080-0805 Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: Department of Surgery, Hokkaido Social Work Association Obihiro Hospital, 2 East 5 South 9, Obihiro, Hokkaido 080-0805 Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Hamaguchi
authors.affiliation: Department of Clinical Laboratory, Hokkaido Social Work Association Obihiro Hospital, 2 East 5 South 9, Obihiro, Hokkaido 080-0805 Japan.
authors.forename: Terumi
authors.initials: T
authors.lastname: Kaga
authors.affiliation: Department of Clinical Laboratory, Hokkaido Social Work Association Obihiro Hospital, 2 East 5 South 9, Obihiro, Hokkaido 080-0805 Japan.
authors.forename: Mami
authors.initials: M
authors.lastname: Sato
authors.affiliation: Department of Clinical Laboratory, Hokkaido Social Work Association Obihiro Hospital, 2 East 5 South 9, Obihiro, Hokkaido 080-0805 Japan.
authors.forename: Masako
authors.initials: M
authors.lastname: Oomura
authors.affiliation: Department of Clinical Laboratory, Hokkaido Social Work Association Obihiro Hospital, 2 East 5 South 9, Obihiro, Hokkaido 080-0805 Japan.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Takata
authors.affiliation: Department of Clinical Laboratory, Hokkaido Social Work Association Obihiro Hospital, 2 East 5 South 9, Obihiro, Hokkaido 080-0805 Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Fujibe
authors.affiliation: Department of Clinical Laboratory, Hokkaido Social Work Association Obihiro Hospital, 2 East 5 South 9, Obihiro, Hokkaido 080-0805 Japan.
authors.forename: Chie
authors.initials: C
authors.lastname: Takeda
authors.affiliation: Department of Clinical Laboratory, Hokkaido Social Work Association Obihiro Hospital, 2 East 5 South 9, Obihiro, Hokkaido 080-0805 Japan.
authors.forename: Etsuya
authors.initials: E
authors.lastname: Tamura
authors.affiliation: Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-Ku, Sapporo, Hokkaido 060-8638 Japan.
authors.forename: Akinobu
authors.initials: A
authors.lastname: Taketomi
authors.affiliation: Department of Surgery, Hokkaido Social Work Association Obihiro Hospital, 2 East 5 South 9, Obihiro, Hokkaido 080-0805 Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kyuno
keywords: Axillary lymph node metastasis; Breast cancer; Contrast enhanced ultrasonography; Sentinel lymph node; Sentinel lymph node biopsy; Sonazoid