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

Reitsamer, Roland; Peintinger, Florentia; Forsthuber, Ernst-Pius; Sir, Andreas

doi:10.1016/j.breast.2021.03.008

Cited by 28 publications

(21 citation statements)

References 20 publications

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“…In most studies on lymph node marking with magnetic seeds, the seeds are placed after NAST [ 19 ]. Our results indicate that placing them earlier does not interfere with patients' follow-up, regardless of the molecular classification of their cancer and response to NAST.…”

Section: Discussionmentioning

confidence: 99%

“…Most studies to date have examined the use of Magseed® placement after NAST [ 19 ]. The aim of this one-year, multicenter study was to assess the reliability of lymph node marking with Magseed® both before and after NAST, as well as seed retrieval during surgery with a handheld magnetometer system (Sentimag®), in patients diagnosed with T1-T3 breast cancer involvement (cN1, 1–4 suspected nodes) prior to NAST.…”

Section: Introductionmentioning

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: 99%

Section: Introductionmentioning

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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“…In our study, we only included metallic markers and no other types of markers like magnetic seeds or radiofrequency identification tags, because they are not currently used in clinical practice in our institution. However it is known that magnetic seeds and radiofrequency identifier tags are associated with much more prominent signal voids due to susceptibility artifacts in MRI with sizes of up to 5-6 cm [27,28].To our opinion this is a prohibiting factor for realizing an MR scan at all.…”

Section: Tablementioning

confidence: 85%

Diagnostic precision of breast MRI in prediction of pathological complete response: Is it influenced by the presence of metallic markers?

Matthias

Bruyère

Sfakianaki

et al. 2022

European Journal of Radiology

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“…The published studies reporting on Magseed use in the NACT setting use Magseed to localise previously clipped nodes to facilitate targeted axillary dissection. 14,15 To our knowledge, this is the first study documenting the use of Magseed in patients undergoing NACT where Magseeds have been placed before or during NACT for the localisation of breast lesions in BCS. Worldwide the use of NACT for breast cancer is increasing.…”

Section: Discussionmentioning

confidence: 97%

Magseed placement before neoadjuvant chemotherapy to facilitate subsequent breast-conserving surgery – a single-centre audit

et al. 2022

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BACKGROUND: A radio-opaque clip is placed in all patients planned for breast-conserving surgery (BCS) receiving neoadjuvant chemotherapy (NACT) to localise the tumour bed in case response to chemotherapy makes later localisation impossible. A tumour that was localised with a radio-opaque clip before NACT will then need a second localisation procedure, after the completion of NACT to aid BCS. The two most commonly used methods are hookwire and radio-guided occult lesion localisation. Magseed®, a newly available technology consisting of a small magnetic seed, has now become available. The seed is placed instead of a radio-opaque clip before the start of or during NACT and can remain in place until the time of BCS. METHODS: A retrospective cohort study was performed, collecting data on patients who had a Magseed placed before or during NACT from December 2018 to February 2020. RESULTS: Twenty-one Magseed devices were placed into the breasts of 20 patients, 18 under ultrasound guidance, and three under stereotactic guidance. The average breast volume of individuals who had seeds placed was 1 532 g ± 869 g. The duration that the seeds were in situ was 138 days ± 45 days. All preoperatively placed seeds were retrieved at the surgery with no observed migration outside the tumour bed. CONCLUSION: Magseed placement before NACT is a safe and technically simple technique that can be done under ultrasound guidance in the majority of cases. It has the advantage of being a single procedure with an associated reduction in time off work and travel cost to the patient, as well as flexibility in terms of the time of placement.

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

Cited by 28 publications

References 20 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 precision of breast MRI in prediction of pathological complete response: Is it influenced by the presence of metallic markers?

Magseed placement before neoadjuvant chemotherapy to facilitate subsequent breast-conserving surgery – a single-centre audit

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