Axillary Lymph Node Tattooing and Targeted Axillary Dissection in Breast Cancer Patients Who Presented as cN+ Before Neoadjuvant Chemotherapy and Became cN0 After Treatment

Natsiopoulos, Ioannis; Intzes, Stavros; Liappis, Triantafyllos; Zarampoukas, Konstantinos; Zarampoukas, Thomas; Zacharopoulou, Vasiliki; Papazisis, Konstantinos

doi:10.1016/j.clbc.2019.01.013

Cited by 62 publications

(46 citation statements)

References 34 publications

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“…Natsiopoulos et al. described an identification rate of 94.6% (71/75 patients) [ 12 ]. Correspondence between tattooed nodes and SLNs could be observed in 75.3% (53/70 patients).…”

Section: Discussionmentioning

confidence: 99%

“…In small series several methods for TLNB are described. Methods as wire localization of clipped nodes [ [6] , [7] , [8] , [9] ], tattooing of positive nodes [ [10] , [11] , [12] , [13] ], magnetic localization of the clipped nodes [ 14 , 15 ] or radiofrequency identification tags (RFID) [ [16] , [17] , [18] ] are under investigation. We report on the feasibility and first results with Magseed® localization of the clipped lymph node after NAC.…”

Section: Introductionmentioning

confidence: 99%

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The applicability of Magseed® for targeted axillary dissection in breast cancer patients treated with neoadjuvant chemotherapy

et al. 2021

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Background Targeted axillary dissection (TAD), the combination of sentinel lymph node biopsy (SLNB) and targeted lymph node biopsy (TLNB), can reduce the false negative rates of sentinel node biopsy alone dramatically in breast cancer patients, who received neoadjuvant chemotherapy (NAC). However methods for TAD are still under investigation. Methods Magseed®, a non-radioactive magnetic marker was used to mark the biopsied positive TLN after NAC. The SLNB with the standard technetium-based method and the selective TLNB with Magseed® localization were performed in 40 patients. The TLNs were identified with the Sentimag® probe and excised in all patients. Specimen x-ray was performed to confirm the Magseed® within the prior to NAC biopsied and clipped lymph node. Results The TLN identification rate was 100% (40/40), the SLN identification rate was 82.5% (33/40), the concordance rate between the TLN and the SLN was 65% (26/40). Complications according Magseed® deployment or identification could not be observed. Conclusion Magseed® is a reliable and feasible marker for the identification of TLNs after NAC.

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“…Natsiopoulos et al. described an identification rate of 94.6% (71/75 patients) [ 12 ]. Correspondence between tattooed nodes and SLNs could be observed in 75.3% (53/70 patients).…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The applicability of Magseed® for targeted axillary dissection in breast cancer patients treated with neoadjuvant chemotherapy

et al. 2021

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“…Options vary between the largest, the "most suspicious", or the best accessible lymph node [8,47]. Other authors report marking of all suspicious nodes [42,48]. Both strategies offer their own advantages and disadvantages (Table 6).…”

Section: How Many Nodes Should Be Marked?mentioning

confidence: 99%

“…Concerning arm morbidity, marking all suspicious nodes will necessarily result in removal of more lymph nodes. Natsiopoulos et al conducted carbon solution-based TAD (Spot ® , GI Supply, Inc., Mechanicsburg, PA, USA) in 75 patients [48], marking each biopsy-proven or strongly suspicious node (median 2, range 1-5). At surgery, 2-10 nodes (median 4) were retrieved.…”

Section: How Many Nodes Should Be Marked?mentioning

confidence: 99%

“…If a minimally invasive biopsy is performed, the marker may be inserted into the same lymph node(s) at the same session or at a second session upon confirmation of metastasis by pathology/cytology. Data on this aspect lack detail in available studies but most authors report the placement of the marker into the "previously proven" node [44,48]. In contrast, marking of the suspicious lymph node immediately after the biopsy is reported by others [31,52].…”

Section: When Should Lymph Nodes Be Marked?mentioning

confidence: 99%

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Surgical Management of the Axilla in Clinically Node-Positive Breast Cancer Patients Converting to Clinical Node Negativity through Neoadjuvant Chemotherapy: Current Status, Knowledge Gaps, and Rationale for the EUBREAST-03 AXSANA Study

Banys‐Paluchowski

Gasparri

Boniface

et al. 2021

Cancers

106

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In the last two decades, surgical methods for axillary staging in breast cancer patients have become less extensive, and full axillary lymph node dissection (ALND) is confined to selected patients. In initially node-positive patients undergoing neoadjuvant chemotherapy, however, the optimal management remains unclear. Current guidelines vary widely, endorsing different strategies. We performed a literature review on axillary staging strategies and their place in international recommendations. This overview defines knowledge gaps associated with specific procedures, summarizes currently ongoing clinical trials that address these unsolved issues, and provides the rationale for further research. While some guidelines have already implemented surgical de-escalation, replacing ALND with, e.g., sentinel lymph node biopsy (SLNB) or targeted axillary dissection (TAD) in cN+ patients converting to clinical node negativity, others recommend ALND. Numerous techniques are in use for tagging lymph node metastasis, but many questions regarding the marking technique, i.e., the optimal time for marker placement and the number of marked nodes, remain unanswered. The optimal number of SLNs to be excised also remains a matter of debate. Data on oncological safety and quality of life following different staging procedures are lacking. These results provide the rationale for the multinational prospective cohort study AXSANA initiated by EUBREAST, which started enrollment in June 2020 and aims at recruiting 3000 patients in 20 countries (NCT04373655; Funded by AGO-B, Claudia von Schilling Foundation for Breast Cancer Research, AWOgyn, EndoMag, Mammotome, and MeritMedical).

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A nomogram for predicting axillary node pathologic complete response—A necessary component of the path toward true axillary de‐escalation but needs a clear definition of the research question and a robust study design

Garg,

Thorat

2024

Cancer

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Axillary Lymph Node Tattooing and Targeted Axillary Dissection in Breast Cancer Patients Who Presented as cN+ Before Neoadjuvant Chemotherapy and Became cN0 After Treatment

Cited by 62 publications

References 34 publications

The applicability of Magseed® for targeted axillary dissection in breast cancer patients treated with neoadjuvant chemotherapy

The applicability of Magseed® for targeted axillary dissection in breast cancer patients treated with neoadjuvant chemotherapy

Surgical Management of the Axilla in Clinically Node-Positive Breast Cancer Patients Converting to Clinical Node Negativity through Neoadjuvant Chemotherapy: Current Status, Knowledge Gaps, and Rationale for the EUBREAST-03 AXSANA Study

A nomogram for predicting axillary node pathologic complete response—A necessary component of the path toward true axillary de‐escalation but needs a clear definition of the research question and a robust study design

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