Advantages of preoperative localization and surgical resection of metastatic axillary lymph nodes using magnetic seeds after neoadjuvant chemotherapy in breast cancer

Martínez, Alberto Pastor; Roselló, Irene Vives; Gómez, Angela Salazar; Catanese, Alessandro; Molina, Mariola Pérez; Suárez, Montserrat Solà; Miguel, Iciar Pascual; Blay, Lidia; Gozálvez, C. Ríos; Ibáñez, José Francisco Julián; Martínez, Paula Rodríguez; Román, S. Martínez; Vila, Mireia Margelí; Tomás, Miguel Ángel Luna

doi:10.1016/j.suronc.2020.11.013

Cited by 32 publications

(19 citation statements)

References 32 publications

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“…We obtained a higher concordance rate between MLNs and SLNs than Mariscal Martínez et al [ 14 ] Their study found that in breast cancer patients with axillary lymph node involvement treated with neoadjuvant chemotherapy, the Sentimag®-MLN corresponded to the SLN in 50% of cases. They, and others [ 10 , 23 ], have shown that removing SLNs and MLNs can reduce the FNR associated with SLNB alone from well over 10% to between 6 and 2%.…”

Section: Discussionmentioning

confidence: 51%

“…A single seed was placed in all but one case, in which two seeds were placed, one in the most caudal and one in the most cranial node that looked equally suspicious. The magnetic seeds were guided by ultrasound and released in the cortical area of maximum thickness as previously described [ 14 ]. The release of the marker was confirmed by ultrasound and mammogram.…”

Section: Methodsmentioning

confidence: 99%

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Evaluation of Axillary Lymph Node Marking with Magseed® before and after Neoadjuvant Systemic Therapy in Breast Cancer Patients: MAGNET Study

et al. 2022

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Background. Due to the high false negative rate (FNR) associated with sentinel lymph node biopsy (SLNB) after neoadjuvant systemic therapy (NAST), the standard surgical treatment for patients with an initially positive axilla and indicated for NAST is axillary lymph node dissection (ALND). To avoid unnecessary ALND, this multicenter, prospective, observational study aimed to determine the effectiveness and ease of using magnetic seeds (Magseed®) for targeted axillary dissection (TAD) when the seeds are placed before or after NAST. Materials and Methods. We recruited 81 patients diagnosed with T1-T3 breast cancer, with clinically/radiologically positive nodal involvement (cN1, 75 patients with 1–3 nodes suspected nodes and 6 patients with up to 4 suspected nodes) prior to NAST. Positive nodes detected by fine-needle aspiration biopsy or core needle biopsy were marked with a stainless steel marker coil and after NAST with Magseed® prior to surgery (Post-NAST group), or directly with Magseed® before NAST (Pre-NAST group). The correlation between lymph nodes marked with Magseed® (MLNs) and sentinel lymph nodes (SLNs) was calculated based on pathologic assessment with the OSNA assay (Sysmex Corporation, Kobe) or conventional sectioning and staining techniques according to the standard protocols of each center. Results. All magnetic seeds were successfully identified and retrieved in just over 10 minutes of surgery, guided by the Sentimag® magnetometer system. The overall concordance rate between MLNs and SLNs was 81.5%, and the concordance between MLNs and SLNs with metastasis was 93.8%. Metastasis was detected in 54.3% of the MLNs compared with 48.1% of SLNs. In cases that presented negative MLN and negative SLN (negative TAD), the FNR was 0%. No significant differences were found between the Post-NAST and Pre-NAST groups. Conclusions. Our results validate the use of Magseed® for long-term marking of axillary lymph nodes and show that when used in combination with SLNB for TAD, a FNR of 0% can be achieved, avoiding unnecessary ALND.

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Section: Discussionmentioning

confidence: 51%

Section: Methodsmentioning

confidence: 99%

Evaluation of Axillary Lymph Node Marking with Magseed® before and after Neoadjuvant Systemic Therapy in Breast Cancer Patients: MAGNET Study

et al. 2022

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“…Small data on marking nodes with magnetic seeds and SAVI SCOUT (using infrared light and a microimpulse radar reflector) were reported. 49 , 50 , 51 Their advantage was more pinpoint positioning, while the disadvantage was a poorer exploration of deep nodes due to the limitations of unique detectors. Radiofrequency identification (RFID) devices were likewise reported in TLNB, with only scarce evidence.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of de‐escalated surgical procedure in axilla for node‐positive breast cancer patients treated with neoadjuvant systemic therapy: A systematic review and meta‐analysis

Song

Liang

et al. 2022

Cancer Medicine

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“…Given the idea that a combination procedure is most accurate for axillary staging after NST, and radioactive iodine seeds are not allowed to be used for this purpose in various countries, several variations of TAD have been investigated. Mostly in small and retrospective cohorts, markers such as wire [32-34], carbon ink [35-38], magnetic seeds [39, 40], and clips [29] have been used, which all have certain benefits and downsides with regard to identifying the marked lymph node. Wire, carbon ink, and clips are non-radioactive and less expensive than radioactive iodine and magnetic seeds, and therefore often preferred options for TAD.…”

Section: Targeted Axillary Dissection: Markersmentioning

confidence: 99%

De-Escalating Axillary Surgery in Node-Positive Breast Cancer Treated with Neoadjuvant Systemic Therapy

et al. 2021

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Background: There is a trend towards de-escalating axillary staging and treatment in breast cancer patients. On account of neoadjuvant systemic therapy, node-positive breast cancer patients can achieve a pathological complete response of the axilla. It is hypothesized that these patients do not benefit from an axillary lymph node dissection (ALND), and thus may be spared the risk of severe post-surgical morbidity. In an effort to omit standard ALND, less invasive axillary staging procedures are being implemented to establish response-guided treatment. However, it is unclear which less invasive staging procedure is most accurate, and long-term data are missing with regard to their oncologic safety. Summary: This article provides an overview of the literature on currently used less invasive axillary staging procedures, the accuracy and feasibility of these procedures in clinical practice, important issues concerning axillary treatment, and issues to be addressed in ongoing or future studies. Key messages: More evidence is needed regarding the safety of replacing standard ALND by less invasive axillary staging procedures in terms of long-term prognosis. These less invasive staging procedures not only serve to select patients who may benefit from treatment de-escalation, but also to select patients who may benefit from treatment escalation.

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Advantages of preoperative localization and surgical resection of metastatic axillary lymph nodes using magnetic seeds after neoadjuvant chemotherapy in breast cancer

Cited by 32 publications

References 32 publications

Evaluation of Axillary Lymph Node Marking with Magseed® before and after Neoadjuvant Systemic Therapy in Breast Cancer Patients: MAGNET Study

Evaluation of Axillary Lymph Node Marking with Magseed® before and after Neoadjuvant Systemic Therapy in Breast Cancer Patients: MAGNET Study

Diagnostic accuracy of de‐escalated surgical procedure in axilla for node‐positive breast cancer patients treated with neoadjuvant systemic therapy: A systematic review and meta‐analysis

De-Escalating Axillary Surgery in Node-Positive Breast Cancer Treated with Neoadjuvant Systemic Therapy

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