Moody AN, et al. – The aim of this work was to conduct a systematic review and meta–analysis to assess whether contrast–enhanced ultrasound (CEUS)–guided core biopsy of the sentinel lymph node (SLN) could identify metastatic nodes preoperatively and reduce the number of surgical SLN biopsies in patients with breast cancer and normal axillary B–mode ultrasound; and to establish whether CEUS SLN identification and localisation is a viable alternative to standard lymphatic mapping using isotope and blue dye. CEUS was considered as a promising technique for preoperative staging of the axilla. It was demonstrated that CEUS–guided core biopsy has the potential to identify nodal metastases in over half of patients with normal axillary B–mode ultrasound. Moreover, CEUS–guided identification and localisation of the SLN may offer a viable alternative to standard lymphatic mapping using isotope and blue dye; nevertheless, future prospective studies with larger samples are needed.