Perinodal fibrosis developed after ultrasonography-guided core-needle biopsy of a contrast-enhanced ultrasound-detected sentinel axillary node interferes with subsequent surgical sentinel node dissection

Author(s)

Serquiz, Nicoli ^[1] ; Moro, Luciano ^[2] ; Menossi, Carlos A. ^[1] ; Almeida, Natalie R. ^[1] ; Baccarin, Gabrielle ^[1] ; de Paiva Silva, Geisilene R. ^[1] ; Shinzato, Julia Y. ^[1] ; Derchain, Sophie ^[1] ; Jales, Rodrigo M. ^[1]

Affiliation

^[1] State Univ Campinas Unicamp, Fac Med Sci, Dept Obstet & Gynecol, Imaging Sect, POB 6111, BR-13083970 Campinas, SP - Brazil

^[2] Univ Sao Paulo, Fac Med, Dept Radiol, Sao Paulo, SP - Brazil

• Document type: Journal article
• Source: JOURNAL OF CLINICAL ULTRASOUND; v. 47, n. 8 JULY 2019.
• Web of Science Citations: 0

Abstract

Objective To evaluate perinodal fibrosis after 14-gauge staging core-needle biopsy (CNB) of the axillary sentinel lymph node (SLN) identified using contrast-enhanced ultrasonography (CEUS) and its interference with subsequent surgical SLN dissection in breast cancer patients. Methods Frequencies or means of main clinical, sonographic, pathological, and surgical characteristics were calculated. We also compared patient groups with and without perinodal pathological fibrosis. Results Forty-eight patients who underwent CEUS + CNB and axillary surgery were eligible for this cross-sectional study. Axillary surgical specimens showed perinodal fibrosis in 9/48 (18.7%) patients. Interference with SLN dissection was reported in 4/48 (8.3%) patients (two hematomas, three abnormal palpation findings, and four difficult dissections). The overall surgical detection rate of SLN was 43/48 (89.6%). In the majority of cases, perinodal fibrosis was described as moderate (4/9 {[}44.4%]) or severe (4/9 {[}44.4%]). The mean time elapsed between CEUS + CNB and axillary dissection was shorter in patients with perinodal fibrosis (P = .04). Interference with SLN dissection was only reported in patients with perinodal fibrosis (P < .001). Surgical SLN detection was successful in all nine cases in which perinodal pathological fibrosis or interference with SLN dissection was reported. Conclusion Perinodal fibrosis may impair the surgical SLN dissection in early stage breast cancer patients who were staged using CEUS + CNB using a14-gauge needle. (AU)

• FAPESP's process: 15/22438-3 - Performance of percutaneous biopsy of sentinel lymph node axillary fragment detected by ultrasound contrast in the selection of cases with negative armpit or with minimal axillary lymph nodes in women with early breast cancer
• Grantee: Gabrielle Baccarin
• Support Opportunities: Scholarships in Brazil - Scientific Initiation