This house believes that: MARI/TAD is better than sentinel node biopsy after PST for cN+ patients

Hemert, Annemiek K E van; Duijnhoven, Frederieke van; Peeters, Marie‐Jeanne T. F. D. Vrancken

doi:10.1016/j.breast.2023.06.011

Cited by 4 publications

(3 citation statements)

References 63 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These data show that implementation of de-escalation of axillary treatment with the TAD procedure appear to be successful. In another study, TAD, assisted by 125 I seed localisation of lymph nodes, prevented ALND in 80% of cN+ patients with a three-year axillary recurrence-free rate of 98% [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Assessing the Efficacy of Radioactive Iodine Seed Localisation in Targeted Axillary Dissection for Node-Positive Early Breast Cancer Patients Undergoing Neoadjuvant Systemic Therapy: A Systematic Review and Pooled Analysis

Alamoodi,

Wazir,

Venkataraman

et al. 2024

Diagnostics

View full text Add to dashboard Cite

Targeted axillary dissection (TAD), employing marked lymph node biopsy (MLNB) alongside sentinel lymph node biopsy (SLNB), is increasingly recognised for its efficacy in reducing false negative rates (FNRs) in node-positive early breast cancer patients receiving neoadjuvant systemic therapy (NST). One such method, 125I radioactive seed localisation (RSL), involves implanting a seed into a biopsy-proven lymph node either pre- or post-NST. This systematic review and pooled analysis aimed to assess the performance of RSL in TAD among node-positive patients undergoing NST. Six studies, encompassing 574 TAD procedures, met the inclusion criteria. Results showed a 100% successful deployment rate, with a 97.6% successful localisation rate and a 99.8% retrieval rate. Additionally, there was a 60.0% concordance rate between SLNB and MLNB. The FNR of SLNB alone was significantly higher than it was for MLNB (18.8% versus 5.3%, respectively; p = 0.001). Pathological complete response (pCR) was observed in 44% of cases (248/564). On average, the interval from 125I seed deployment to surgery was 75.8 days (range: 0–272). These findings underscore the efficacy of RSL in TAD for node-positive patients undergoing NST, enabling precise axillary pCR identification and facilitating the safe omission of axillary lymph node dissection.

show abstract

Section: Discussionmentioning

confidence: 99%

Assessing the Efficacy of Radioactive Iodine Seed Localisation in Targeted Axillary Dissection for Node-Positive Early Breast Cancer Patients Undergoing Neoadjuvant Systemic Therapy: A Systematic Review and Pooled Analysis

Alamoodi,

Wazir,

Venkataraman

et al. 2024

Diagnostics

View full text Add to dashboard Cite

show abstract

“…These data indicate that the de-escalation of axillary treatment with the TAD procedure has been successful. In another study, TAD assisted by 125I seed localisation of lymph nodes avoided ALND in 80% of cN+ patients, with a three-year axillary recurrence-free interval (ARFI) of 98% [ 38 ]. The five-year data from NSABP B-51 confirm the safety of axillary treatment de-escalation.…”

Section: Discussionmentioning

confidence: 99%

Wire-Free Targeted Axillary Dissection: A Pooled Analysis of 1300+ Cases Post-Neoadjuvant Systemic Therapy in Node-Positive Early Breast Cancer

Varghese,

Patani,

Wazir

et al. 2024

Cancers

View full text Add to dashboard Cite

Recent advances in neoadjuvant systemic therapy (NST) have significantly improved pathologic complete response rates in early breast cancer, challenging the role of axillary lymph node dissection in nose-positive patients. Targeted axillary dissection (TAD) integrates marked lymph node biopsy (MLNB) and tracer-guided sentinel lymph node biopsy (SLNB). The introduction of new wire-free localisation markers (LMs) has streamlined TAD and increased its adoption. The primary endpoints include the successful localisation and retrieval rates of LMs. The secondary endpoints include the pathological complete response (pCR), SLNB, and MLNB concordance, as well as false-negative rates. Seventeen studies encompassing 1358 TAD procedures in 1355 met the inclusion criteria. The localisation and retrieval rate of LMs were 97% and 99%. A concordance rate of 67% (95% CI: 64–70) between SLNB and MLNB was demonstrated. Notably, 49 days (range: 0–272) was the average LM deployment time to surgery. pCR was observed in 46% (95% CI: 43–49) of cases, with no significant procedure-related complications. Omitting MLNB or SLNB would have under-staged the axilla in 15.2% or 5.4% (p = 0.0001) of cases, respectively. MLNB inclusion in axillary staging post-NST for initially node-positive patients is crucial. The radiation-free Savi Scout, with its minimal MRI artefacts, is the preferred technology for TAD.

show abstract

“…For this Special Issue, we have invited outstanding, international experts to provide an overview of the current situation for both surgical and radiation treatments as well as to share their view on future perspectives, taking into account the potential adverse consequences of too hasty de-escalation [ [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] ]. “Time to find a balance” is, in fact, the subtitle of this monographic work; a document that aims to give the reader a broader/more in-depth vision of the potential implications of this ongoing process.…”

mentioning

confidence: 99%

De-escalation of loco-regional treatments: Time to find a balance

Gentilini,

Cardoso,

Senkus

et al. 2024

The Breast

View full text Add to dashboard Cite

This house believes that: MARI/TAD is better than sentinel node biopsy after PST for cN+ patients

Cited by 4 publications

References 63 publications

Assessing the Efficacy of Radioactive Iodine Seed Localisation in Targeted Axillary Dissection for Node-Positive Early Breast Cancer Patients Undergoing Neoadjuvant Systemic Therapy: A Systematic Review and Pooled Analysis

Assessing the Efficacy of Radioactive Iodine Seed Localisation in Targeted Axillary Dissection for Node-Positive Early Breast Cancer Patients Undergoing Neoadjuvant Systemic Therapy: A Systematic Review and Pooled Analysis

Wire-Free Targeted Axillary Dissection: A Pooled Analysis of 1300+ Cases Post-Neoadjuvant Systemic Therapy in Node-Positive Early Breast Cancer

De-escalation of loco-regional treatments: Time to find a balance

Contact Info

Product

Resources

About