Enhanced Axillary Evaluation Using Reflector-Guided Sentinel Lymph Node Biopsy: A Prospective Feasibility Study and Comparison With Conventional Lymphatic Mapping Techniques

Taback, Bret; Jadeja, Priya; Ha, Richard

doi:10.1016/j.clbc.2018.02.001

Cited by 31 publications

(18 citation statements)

References 25 publications

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“…In previous cohorts that received combination procedures, sometimes ten or more lymph nodes were retrieved, even though these procedures aim to offer a less invasive alternative to ALND. In the present cohort, only one to three lymph nodes were excised in half of the patients.…”

Section: Discussionmentioning

confidence: 99%

Excision of both pretreatment marked positive nodes and sentinel nodes improves axillary staging after neoadjuvant systemic therapy in breast cancer

Simons

Pelt

Marinelli

et al. 2019

British Journal of Surgery

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Background: Marking the axilla with radioactive iodine seed and sentinel lymph node (SLN) biopsy have been proposed for axillary staging after neoadjuvant systemic therapy in clinically node-positive breast cancer. This study evaluated the identification rate and detection of residual disease with combined excision of pretreatment-positive marked lymph nodes (MLNs) together with SLNs. Methods: This was a multicentre retrospective analysis of patients with clinically node-positive breast cancer undergoing neoadjuvant systemic therapy and the combination procedure (with or without axillary lymph node dissection). The identification rate and detection of axillary residual disease were calculated for the combination procedure, and for MLNs and SLNs separately. Results: At least one MLN and/or SLN(s) were identified by the combination procedure in 138 of 139 patients (identification rate 99⋅3 per cent). The identification rate was 92⋅8 per cent for MLNs alone and 87⋅8 per cent for SLNs alone. In 88 of 139 patients (63⋅3 per cent) residual axillary disease was detected by the combination procedure. Residual disease was shown only in the MLN in 20 of 88 patients (23 per cent) and only in the SLN in ten of 88 (11 per cent), whereas both the MLN and SLN contained residual disease in the remainder (58 of 88, 66 per cent).

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Section: Discussionmentioning

confidence: 99%

Excision of both pretreatment marked positive nodes and sentinel nodes improves axillary staging after neoadjuvant systemic therapy in breast cancer

Simons

Pelt

Marinelli

et al. 2019

British Journal of Surgery

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“…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%

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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“…The radioactive seed carries radiation exposure and requires radiation safety precautions and handling . Other promising modalities include a radar breast localization system (Savi Scout), Magseed or radiofrequency identification technology predominantly used for breast lesions. These devices have no radiation risk and can avoid the use of wire.…”

Section: Discussionmentioning

confidence: 99%

“…Wire localization may be associated with wire migration/breakage and patient discomfort and is not always technically possible. Savi Scout reflector‐guided localization and magnetic seed localization (Magseed) are promising devices but are expensive and not readily available worldwide. To date, several ongoing worldwide trials are still assessing the feasibility of radioactive seed (Radioactive Iodine Seed localization in the Axilla with the Sentinel node – RISAS trial), Magseed (ClinicalTrials.gov identifier: ) and scout reflector (ClinicalTrials.gov identifier: ), etc as localizing agents for the clipped node post‐NACT.…”

Section: Introductionmentioning

confidence: 99%

Initial results of a novel technique of clipped node localization in breast cancer patients postneoadjuvant chemotherapy: Skin Mark clipped Axillary nodes Removal Technique (SMART trial)

et al. 2020

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Purpose Removal of clipped nodes can improve sentinel node biopsy accuracy in breast cancer patients post neoadjuvant chemotherapy (NACT). However, the current methods of clipped node localization have limitations. We evaluated the feasibility of a novel clipped node localization and removal technique by preoperative skin marking of clipped nodes and removal by the Skin Mark clipped Axillary nodes Removal Technique (SMART), with the secondary aim of assessing the ultrasound visibility of the various clips in the axillary nodes after NACT. Methods Invasive breast cancer patients with histologically metastatic axillary nodes, going for NACT, and ≤3 sonographically abnormal axillary nodes were recruited. All abnormal nodes had clips inserted. Patients with M1 disease were excluded. Post‐NACT, patients underwent SMART and axillary lymph node dissection. Specimen radiography and pathological analyses were performed to confirm the clipped node presence. Success, complication rates of SMART, and ultrasound visibility of the various clips were assessed. Results Twenty‐five clipped nodes in 14 patients underwent SMART without complications. The UltraCor Twirl, hydroMARK, UltraClip Dual Trigger, and UltraClip were removed in 13/13 (100%), 7/9 (77.8%), 1/2 (50.0%), and 0/1 (0%), respectively (P = .0103) with UltraCor Twirl having the best ultrasound visibility and removal rate. Removal of three clipped nodes in the same patient (P = .0010) and deeply seated clipped nodes (P = .0167) were associated with SMART failure. Conclusion Skin Mark clipped Axillary nodes Removal Technique is feasible for removing clipped nodes post‐NACT, with 100% observed success rate, using the UltraCor Twirl marker in patients with <3 not deeply seated clipped nodes. Larger studies are needed for validation.

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Enhanced Axillary Evaluation Using Reflector-Guided Sentinel Lymph Node Biopsy: A Prospective Feasibility Study and Comparison With Conventional Lymphatic Mapping Techniques

Cited by 31 publications

References 25 publications

Excision of both pretreatment marked positive nodes and sentinel nodes improves axillary staging after neoadjuvant systemic therapy in breast cancer

Excision of both pretreatment marked positive nodes and sentinel nodes improves axillary staging after neoadjuvant systemic therapy in breast cancer

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

Initial results of a novel technique of clipped node localization in breast cancer patients postneoadjuvant chemotherapy: Skin Mark clipped Axillary nodes Removal Technique (SMART trial)

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