Sentinel Node Detection in Breast Cancer Using Contrast-Enhanced Sonography with 25% Albumin—Initial Clinical Experience

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To determine the clinical usefulness of a sentinel lymph node (SLN) identification technique using contrast-enhanced sonography (CEUS) with 25% albumin.


The subjects were 23 women with breast cancer. Each was injected subcutaneously with 5 ml of 25% albumin solution as a negative contrast agent directly superficial to the breast tumor. The area was massaged, and the inferior axillary hairline was examined continuously using gray-scale sonography with a 7.5- or 10-MHz transducer. Any contrast-enhanced lymph node was considered a CEUS-detected SLN, was differentiated from other level I and II nodes, and was resected and pathologically assessed.


In all 23 patients, 1 or 2 CEUS-detected SLNs (mean, 1.3 SLNs) were identified. Their sizes ranged from 5 mm to 25 mm (mean, 11.3 mm), and their depths (from the skin surface) ranged from 5 mm to 20 mm (mean, 12.6 mm). Pathologic examination revealed a metastasis in 5 of the 23 patients, all in CEUS-detected SLNs.


In a clinical study using CEUS with 25% albumin, contrast-enhanced nodes were identified in all subjects. The pathologic findings suggested that any metastatic nodes observed were SLNs, indicating that this technique may represent a new modality for SLN identification.

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