RT Journal Article SR Electronic T1 Contrast-enhanced Ultrasound Using Intradermal Microbubble Sulfur Hexafluoride in Non-invasive Axillary Staging in Breast Cancer: Are we Missing a Chance? JF Anticancer Research JO Anticancer Res FD International Institute of Anticancer Research SP 2021 OP 2030 DO 10.21873/anticanres.17005 VO 44 IS 5 A1 VANNI, GIANLUCA A1 MATERAZZO, MARCO A1 LORENZO, NICOLA DI A1 TACCONI, FEDERICO A1 PELLICCIARO, MARCO A1 BERRETTA, MASSIMILIANO A1 MAURO, GIORDANA DI A1 PISTOLESE, CHIARA ADRIANA A1 NOCE, ANNALISA A1 LONGO, BENEDETTO A1 CERVELLI, VALERIO A1 BUONOMO, ORESTE CLAUDIO YR 2024 UL http://ar.iiarjournals.org/content/44/5/2021.abstract AB Background/Aim: In the context of surgical de-escalation in early breast cancer (EBC), this study aimed to evaluate the contrast enhancement ultrasound (CEUS) sentinel lymph node (SLN) procedure as a non-invasive axillary staging procedure in EBC in comparison with standard SLN biopsy (SLNB). Patients and Methods: A subanalysis of the AX-CES study, a prospective single-arm, monocentric phase 3 study was performed (EudraCT: 2020-000393-20). The study included patients with EBC undergoing upfront surgery and SLN resection, with no prior history of locoregional treatment, and weighing between 40-85 kg. All patients underwent the CEUS SLN procedure as a non-invasive axillary staging procedure, with CEUS SLN accumulation marked using blue dye. After the CEUS SLN procedure, all patients underwent the standard mapping procedure. Data on success rate, systemic reactions, mean procedure time, mean surgical procedure, mean procedure without axillary staging, CEUS SLN appearance (normal/pathological), SLN number, and concordance with standard mapping procedure were collected. Results: After the CEUS SLN procedure, 29 LNs among 16 patients were identified and marked. In all cases, CEUS SLN revealed at least one LN enhancement. Six (37.50%) LNs were defined as pathological after the CEUS SLN procedure. Definitive staining of CEUS SLN pathology revealed metastatic involvement in four (66.67%) of the cases. Two SLNs were identified during the CEUS SLN procedure; however, owing to the low disease burden, no change in the surgical plan was reported. Conclusion: The CEUS SLN procedure shows promise as a technique for non-invasive assessment of the axilla, potentially enabling safe axillary de-escalation in EBC by estimating the axillary disease burden.