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Axillary Nodal Staging with Contrast-Enhanced Ultrasound

PURPOSE OF REVIEW: Axillary staging in the context of breast cancer is a contentious topic due to the varied practices across UK, Europe, and America. The ACOSOG Z0011 trial has questioned the role of axillary ultrasound in women with breast cancer. Published data has shown that women with ultrasoun...

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Autores principales: Sharma, Nisha, Cox, Karina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5694501/
https://www.ncbi.nlm.nih.gov/pubmed/29201278
http://dx.doi.org/10.1007/s12609-017-0258-3
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author Sharma, Nisha
Cox, Karina
author_facet Sharma, Nisha
Cox, Karina
author_sort Sharma, Nisha
collection PubMed
description PURPOSE OF REVIEW: Axillary staging in the context of breast cancer is a contentious topic due to the varied practices across UK, Europe, and America. The ACOSOG Z0011 trial has questioned the role of axillary ultrasound in women with breast cancer. Published data has shown that women with ultrasound-positive lymph nodes have a worse prognosis than those with ultrasound-negative lymph nodes. Axillary ultrasound is limited as the sentinel lymph node (SLN) cannot be identified using B-mode ultrasound; however, with the advent of contrast-enhanced ultrasound (CEUS), this has now changed. RECENT FINDINGS: The published literature has shown that the sentinel lymph node can be identified using CEUS. The rates are equivalent to blue dye alone but currently inferior to the dual technique of sentinel lymph node biopsy. There are several different contrast agents that can be used and the agents that remain in the sentinel lymph node for longer can identify areas of poor enhancement, allowing for targeted biopsy. SUMMARY: CEUS has the potential to revolutionize the way we manage the axilla in the future and may even replace surgical staging.
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spelling pubmed-56945012017-11-30 Axillary Nodal Staging with Contrast-Enhanced Ultrasound Sharma, Nisha Cox, Karina Curr Breast Cancer Rep Breast Cancer Screening and Imaging (HTC Le-Petross and BE Adrada, Section Editors) PURPOSE OF REVIEW: Axillary staging in the context of breast cancer is a contentious topic due to the varied practices across UK, Europe, and America. The ACOSOG Z0011 trial has questioned the role of axillary ultrasound in women with breast cancer. Published data has shown that women with ultrasound-positive lymph nodes have a worse prognosis than those with ultrasound-negative lymph nodes. Axillary ultrasound is limited as the sentinel lymph node (SLN) cannot be identified using B-mode ultrasound; however, with the advent of contrast-enhanced ultrasound (CEUS), this has now changed. RECENT FINDINGS: The published literature has shown that the sentinel lymph node can be identified using CEUS. The rates are equivalent to blue dye alone but currently inferior to the dual technique of sentinel lymph node biopsy. There are several different contrast agents that can be used and the agents that remain in the sentinel lymph node for longer can identify areas of poor enhancement, allowing for targeted biopsy. SUMMARY: CEUS has the potential to revolutionize the way we manage the axilla in the future and may even replace surgical staging. Springer US 2017-11-04 2017 /pmc/articles/PMC5694501/ /pubmed/29201278 http://dx.doi.org/10.1007/s12609-017-0258-3 Text en © The Author(s) 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Breast Cancer Screening and Imaging (HTC Le-Petross and BE Adrada, Section Editors)
Sharma, Nisha
Cox, Karina
Axillary Nodal Staging with Contrast-Enhanced Ultrasound
title Axillary Nodal Staging with Contrast-Enhanced Ultrasound
title_full Axillary Nodal Staging with Contrast-Enhanced Ultrasound
title_fullStr Axillary Nodal Staging with Contrast-Enhanced Ultrasound
title_full_unstemmed Axillary Nodal Staging with Contrast-Enhanced Ultrasound
title_short Axillary Nodal Staging with Contrast-Enhanced Ultrasound
title_sort axillary nodal staging with contrast-enhanced ultrasound
topic Breast Cancer Screening and Imaging (HTC Le-Petross and BE Adrada, Section Editors)
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5694501/
https://www.ncbi.nlm.nih.gov/pubmed/29201278
http://dx.doi.org/10.1007/s12609-017-0258-3
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