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Abstract
Introduction. Preoperative axillary staging in breast cancer has traditionally relied on radiotracer-guided sentinel lymph node (SLN) biopsy. However, this approach is constrained by ionizing radiation exposure, the requirement for dedicated nuclear medicine infrastructure, and the potential for hypersensitivity reactions to adjunctive mapping agents. Contrast-enhanced ultrasound (CEUS) has emerged as a promising non-ionizing alternative. Nevertheless, its widespread clinical use remains limited by the absence of standardized imaging protocols and insufficient characterization of the anatomical and clinical factors that influence mapping accuracy.
Aim. To evaluate the feasibility of contrast-enhanced ultrasound for preoperative visualization of sentinel lymph nodes, defining the indications and limitations of the method.
Materials and Methods. The study included 30 patients with clinically staged cT1-2N0M0 breast cancer. All patients underwent CEUS following subareolar injection of a microbubble contrast agent. Preoperative lymphoscintigraphy and postoperative histological findings were used as control methods.
Results. Lymphatic channels were successfully visualized in 100 % of cases, and SLNs were identified in 90 %. The concordance rate for SLN localization between CEUS and lymphoscintigraphy was 83.3 %.
Conclusion. Contrast-enhanced ultrasound is a promising modality for preoperative SLN mapping, demonstrating high diagnostic performance and a favorable safety profile. However, for its subsequent integration into the preoperative diagnostic algorithm, further standardization of the imaging protocol and validation in multicenter studies are required.
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