Use Of Contrast-enhanced Ultrasonography Combined With Fine Needle Aspiration Biopsy In Diagnosis Of Axillary Lymph Node Status In Breast Cancer

Objective : In this study,ultrasound contrast agent was used to detect the sentinel lymph node in breast cancer patients through inject it to the edge of the areola,and the lymph node was biopsied by fine needle aspiration cytology under the guidance of contrast-enhanced ultrasound.Combined with the developed images,it was comprehensively evaluated whether it was metastatic.The results were compared with two-dimensional ultrasound-related data to investigate the clinical application value of contrast-enhanced ultrasound in breast cancer patients.Method:From January 2017 to August 2017,143 cases from the Breast Center of Dalian Central Hospital were diagnosed as breast cancer patients.Divided into A.B groups.Group A(using a conventional two-dimensional ultrasound-guided lymph node fine needle aspiration biopsy group,n=75)was a puncture confirmed breast cancer patient from January to April 2017.Group B(using contrast-enhanced ultrasound combine with lymph node fine needle aspiration biopsy group,n=68)was a puncturedetermined breast cancer patient from May to August 2017.Axillary lymph node dissection(ALND)was performed in all patients to confirm the status of axillary lymph nodes.Calculate the success rate,accuracy rate and false negative rate(FNR)of lymph node puncture in A and B groups,respectively.Result:In group A(using a conventional two-dimensional ultrasound-guided;n=75),the puncture success rate was 70/75(93.3%),the puncture accuracy rate was64/75(85.3%),and the puncture was false negative rate was 11/37(29.7%);in group B(using contrast-enhanced ultrasound combine with lymph node fine needle aspiration biopsy group,n=68),the success rate of sentinel lymph node puncture under ultrasoundcontrast guidance was 67/68(98.5%).The accuracy rate was 65/68(95.6%)and the false negative rate was 3/31(9.7%).Therefore,the accuracy of puncture in group B was significantly higher than in group A(P = 0.040).Furthermore,the false negative rate of group B was lower than that of group A(P = 0.043).On the other hand,the puncture success rate has no significant difference between the two groups(P = 0.123).Conclusion : Contrast-enhanced ultrasound combined with lymph node fine needle aspiration biopsy can be used to assess the status of sentinel lymph nodes,it has a higher accuracy rate and a lower false negative rate compared with conventional ultrasound-guided lymph node biopsy.In short,it is of great significance in guiding the surgery of axilla.