Volume 17 Supplement 1

British Society of Breast Radiology Annual Scientific Meeting 2015

Open Access

Preoperative identification and biopsy of sentinel lymph nodes using contrast-enhanced ultrasound: the Tunbridge Wells experience

  • Tania De'Silva1,
  • Mohamed Hashem1,
  • Nick Wakeham1,
  • Sarah Kirwan1,
  • Neal Chayya1,
  • Pippa Mills1 and
  • Karina Cox1
Breast Cancer Research201517(Suppl 1):P5

https://doi.org/10.1186/bcr3767

Published: 5 November 2015

Introduction

At Maidstone and Tunbridge Wells NHS Trust, all newly diagnosed breast cancer patients with a normal grey-scale axillary ultrasound have a procedure to identify and biopsy sentinel lymph nodes (SLN) using contrast-enhanced ultrasound (CEUS).

Methods

Retrospective data were collected on patients undergoing a CEUS guided biopsy over a 42-month period at Tunbridge Wells Breast Clinic (TWBC). We compared the results of the first group of patients with the most recent to determine the performance of the test over time.

Results

Between February 2011 and June 2012, 94 patients had a CEUS guided biopsy of SLN. Twenty patients were excluded; five had neoadjuvant therapy, five were unfit for surgery, one had an abnormal grey-scale ultrasound and nine had incomplete data. SLN were visualised in 92% and 83% had a successful SLN core biopsy. The sensitivity of the test to detect SLN metastases was 56%, specificity 100%, negative predictive value 86% and prevalence of lymph node (LN) metastases 27%. Between October 2013 and September 2014, 99 patients had the test. Thirty patients were excluded from the final analysis. SLN were visualised in 86% and 74% had a successful SLN core biopsy. The sensitivity was 69%, specificity 100%, negative predictive value 90% and prevalence of LN metastases 25%.

Conclusion

The percentage of SLN visualised and successfully biopsied in TWBC decreased between the two study periods. These findings may represent a normal fluctuation of the test's performance, be a function of missing data in retrospective collection or the cumulative 'learning-curves' of newly appointed radiologists. This warrants further analysis.

Authors’ Affiliations

(1)
Maidstone and Tunbridge Wells NHS Trust

Copyright

© De'Silva et al. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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