Our Summary

This research looked into whether using a method called contrast-enhanced ultrasound (CEUS) could improve the accuracy of identifying a cancerous ‘sentinel lymph node’ (SLN) - the first lymph node to which cancer is likely to spread from the primary tumor, before surgery.

The researchers reviewed 16 studies and found that the use of CEUS was able to identify the SLN 70-100% of the time. They also found that the risk of cancer spreading to the SLN identified by CEUS was significantly higher than in SLNs not identified by CEUS (26.0% vs 4.6%).

For early-stage breast cancer, the research found that the status of the SLN identified by CEUS was a good indicator of the status of all the SLNs. This method had a sensitivity of 98% and specificity of 100%, suggesting it could significantly improve the accuracy of diagnosing whether the cancer had spread to the lymph nodes.

In simpler terms, this research suggests that using CEUS before surgery can help doctors more accurately find and understand the status of the first lymph node that breast cancer is likely to spread to. This could help with both diagnosing the stage of the disease and planning the best treatment.

FAQs

  1. What is contrast-enhanced ultrasound (CEUS) and how can it help in identifying a cancerous sentinel lymph node?
  2. How does the use of CEUS improve the accuracy of diagnosing whether the cancer has spread to the lymph nodes?
  3. How can CEUS assist in diagnosing the stage of the disease and planning the best treatment for early-stage breast cancer?

Doctor’s Tip

A doctor might tell a patient that using contrast-enhanced ultrasound (CEUS) before surgery for a sentinel lymph node biopsy can improve the accuracy of identifying and understanding the status of the lymph node where cancer is likely to spread. This can help with diagnosing the stage of the disease and planning the best treatment.

Suitable For

Patients who are typically recommended for sentinel lymph node biopsy include those with early-stage breast cancer, melanoma, and other solid tumors. It is especially important for patients with larger tumors, tumors with higher grades, or tumors that are more likely to spread to the lymph nodes. Additionally, patients who have had a previous biopsy that showed cancer cells in the lymph nodes, or those with a history of lymph node involvement in previous cancers, may also be recommended for sentinel lymph node biopsy.

Timeline

Before the sentinel lymph node biopsy:

  • Patient undergoes imaging tests such as ultrasound or MRI to locate the sentinel lymph node
  • Contrast-enhanced ultrasound (CEUS) may be used to improve accuracy in identifying the sentinel lymph node
  • Once the sentinel lymph node is identified, the patient undergoes surgery for the biopsy

After the sentinel lymph node biopsy:

  • Pathology report is generated to determine if cancer cells are present in the sentinel lymph node
  • Results of the biopsy help determine the stage of the cancer and the best course of treatment
  • If cancer is found in the sentinel lymph node, further treatment such as radiation therapy or chemotherapy may be recommended
  • If no cancer is found, the patient may be spared from further aggressive treatments

What to Ask Your Doctor

  1. How does a sentinel lymph node biopsy work and why is it important in the treatment of breast cancer?
  2. What is contrast-enhanced ultrasound and how does it improve the accuracy of identifying the sentinel lymph node?
  3. What are the potential benefits of using contrast-enhanced ultrasound in identifying the sentinel lymph node compared to traditional methods?
  4. Are there any specific risks or side effects associated with undergoing a contrast-enhanced ultrasound for sentinel lymph node biopsy?
  5. How does the accuracy of identifying the sentinel lymph node with contrast-enhanced ultrasound impact treatment decisions for breast cancer patients?
  6. How soon before surgery should the contrast-enhanced ultrasound be performed to accurately identify the sentinel lymph node?
  7. What are the limitations or potential drawbacks of using contrast-enhanced ultrasound for sentinel lymph node biopsy?
  8. Are there any additional tests or procedures that may be recommended based on the results of the contrast-enhanced ultrasound for sentinel lymph node biopsy?
  9. How does the identification of the sentinel lymph node with contrast-enhanced ultrasound affect the overall prognosis and treatment plan for breast cancer patients?
  10. Are there any ongoing research studies or clinical trials investigating the use of contrast-enhanced ultrasound for sentinel lymph node biopsy in breast cancer patients?

Reference

Authors: Cui Q, Dai L, Li J, Xue J. Journal: World J Surg Oncol. 2020 May 29;18(1):112. doi: 10.1186/s12957-020-01890-z. PMID: 32471428