ESSO 45 | Intraoperative ultrasound assessment of sentinel nodes in breast cancer

Picture this. A woman in the operating table. I find a sentinel node and I say, I’m going to remove it and find out whether it’s affected. I have to remove it and send it to the lab. My PhD asks a simple question. What if I didn’t? Limb node status is one of the most important prognostic factors in early breast cancer, and surgery is already doing less from removing many nodes to just the sentinel node and in selected patients to omission of the procedure. And we know ultrasound can measure a node cortex, but almost no one evaluated it at life in the operating room. That’s the gap I wanted to fill. So, we designed a study called Cortex in our center. The concept is state forward. Once we locate the sentinel node, we place a small ultrasound PROBE directly on it, measure the thickness of its cortex, and assess its internal structure. Then we repeat the assessment on the node after it has been removed and Compare everything with the final pathology. results are really encouraging. positive nodes were clearly thicker, and we found a cutoff that worked in real time, but the biggest surprise was the hilum. When it’s displaced, the risk of metastasis rises dramatically. These results are preliminary, but if confirmed, intraoperative ultrasound could reduce, even potentially replace, sentinel node removal, less surgery, less waiting, and a better experience for the patient. That’s what makes my PhD so exciting to me. I would like to thank my entire team, and in particular, Dr. Rubio. Since the moment I joined her team, she has helped me to improve and grow scientifically and professionally. None of this would have been possible without her guidance and support. So, thank you so much.