Preliminary Study On The Value Of Contrast-enhanced Ultrasonography And Indocyanine Green Fluorescence In Sentinel Lymph Node Biopsy Of Breast Cancer

Objective:To investigate the value of two novel tracer methods including contrast-enhanced ultrasonography(CEUS)and fluorescence navigation with indocyanine green(ICG)applied in sentinel lymph node biopsy(SLNB)for breast cancer.Methods:Seventy-one patients with breast cancer diagnosed in Sichuan Provincial People’s Hospital of Sichuan Academy of Medical Sciences between March1,2016 and January 31,2017 were selected.71 cases underwent preoperative ultrasonography and fluoroscopy,66 patients met SLNB.After preoperatively signing informed consent of radical operationand agreeing with SLNB,51 patients were treated with SLNB by a subcutaneous injectionof ultrasound contrast agent(Sono Vue)combined with nanocarbon staining(contrast group),and 15 patients received SLNB by fluorescence navigation with a subcutaneous injection of ICG combined with nanocarbon staining(fluorescence group).Operation in the 2 groups was conducted by the same operation team,which were experienced in SLNB.SLNs found by novel tracer methods were subjected for rapid frozen sections or paraffin sections.With or without metastasis of SLNs,axillary lymph node dissection(ALND)was performed.Data analysis was carried out based on preoperative development of lymphatic vessels and sentinel lymph nodes,intraoperative findings in SLNB,and postoperativepathological state of axillary lymph nodes.Results: In the contrast group,56 patients underwent lymph node CEUS,with development of lymphatic vessels found in 51 patients(developing rate,91.0%).Among the 51 patients with development of lymphatic vessels,47 patients showed development of lymph nodes(success rate,83.9%).Finally,in the 51 patientsundergoing SLNB and ALND,1 patient presented false-negative(false-negative rate,6.25%;).All the 15 patients receiving fluorescence method showed development of lymphatic vessels.In the fluorescence group,the developing rate of lymphatic vessels was 100%;fluorescence-enhanced SLNs were detected in14 patients(success rate,93.3%);1 patient showed false-negative(false-negative rate,14.29%;).Conclusion: 1.CEUS combined with nanocarbon can be applied as a tracer method for SLNs;2.ICG,as a novel lymph node trace applied in SLNB,has prospects for further application regarding existing data;nevertheless,experimental cases are too few and the sample size needs to beenlarged.