Janine M Simons1,2, Marion E Scoggins3, Henry M Kuerer1, Savitri Krishnamurthy4, Wei T Yang3, Aysegul A Sahin4, Yu Shen5, Heather Lin5, Isabelle Bedrosian1, Elizabeth A Mittendorf1,6, Alastair Thompson7, Deanna L Lane3, Kelly K Hunt1, Abigail S Caudle8. 1. Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 2. Department of Surgery, Maastricht University, Maastricht, The Netherlands. 3. Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 4. Department of Anatomic Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 5. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 6. Division of Breast Surgery, Department of Surgery, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA. 7. Department of Surgery, Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA. 8. Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. ascaudle@mdanderson.org.
Abstract
BACKGROUND: Targeted axillary dissection (TAD) involves locating and removing both clipped nodes and sentinel nodes for assessment of the axillary response to neoadjuvant chemotherapy (NAC) by clinically node-positive breast cancer patients. Initial reports described radioactive seeds used for localization, which makes the technique difficult to implement in some settings. This trial was performed to determine whether magnetic seeds can be used to locate clipped axillary lymph nodes for removal. METHODS: This prospective registry trial enrolled patients who had biopsy-proven node-positive disease with a clip placed in the node and treatment with NAC. A magnetic seed was placed under ultrasound guidance in the clipped node after NAC. All the patients underwent TAD. RESULTS: Magnetic seeds were placed in 50 patients by 17 breast radiologists. All the patients had successful seed placement at the first attempt (mean time for localization was 6.1 min; range 1-30 min). The final position of the magnetic seed was within the node (n = 44, 88%), in the cortex (n = 3, 6%), less than 3 mm from the node (n = 2, 4%), or by the clip when the node could not be adequately visualized (n = 1, 2%). The magnetic seed was retrieved at surgery from all the patients. In 49 (98%) of the 50 cases, the clip and magnetic seed were retrieved from the same node. Surgeons rated the transcutaneous and intraoperative localization as easy for 43 (86%) of the 50 cases. No device-related adverse events occurred. CONCLUSIONS: Localization and selective removal of clipped nodes can be accomplished safely and effectively using magnetic seeds.
BACKGROUND: Targeted axillary dissection (TAD) involves locating and removing both clipped nodes and sentinel nodes for assessment of the axillary response to neoadjuvant chemotherapy (NAC) by clinically node-positive breast cancerpatients. Initial reports described radioactive seeds used for localization, which makes the technique difficult to implement in some settings. This trial was performed to determine whether magnetic seeds can be used to locate clipped axillary lymph nodes for removal. METHODS: This prospective registry trial enrolled patients who had biopsy-proven node-positive disease with a clip placed in the node and treatment with NAC. A magnetic seed was placed under ultrasound guidance in the clipped node after NAC. All the patients underwent TAD. RESULTS: Magnetic seeds were placed in 50 patients by 17 breast radiologists. All the patients had successful seed placement at the first attempt (mean time for localization was 6.1 min; range 1-30 min). The final position of the magnetic seed was within the node (n = 44, 88%), in the cortex (n = 3, 6%), less than 3 mm from the node (n = 2, 4%), or by the clip when the node could not be adequately visualized (n = 1, 2%). The magnetic seed was retrieved at surgery from all the patients. In 49 (98%) of the 50 cases, the clip and magnetic seed were retrieved from the same node. Surgeons rated the transcutaneous and intraoperative localization as easy for 43 (86%) of the 50 cases. No device-related adverse events occurred. CONCLUSIONS: Localization and selective removal of clipped nodes can be accomplished safely and effectively using magnetic seeds.
Authors: María Martínez; Sara Jiménez; Florentina Guzmán; Marta Fernández; Elena Arizaga; Consuelo Sanz Journal: Breast J Date: 2022-07-09 Impact factor: 2.269
Authors: Maggie Banys-Paluchowski; Maria Luisa Gasparri; Jana de Boniface; Oreste Gentilini; Elmar Stickeler; Steffi Hartmann; Marc Thill; Isabel T Rubio; Rosa Di Micco; Eduard-Alexandru Bonci; Laura Niinikoski; Michalis Kontos; Guldeniz Karadeniz Cakmak; Michael Hauptmann; Florentia Peintinger; David Pinto; Zoltan Matrai; Dawid Murawa; Geeta Kadayaprath; Lukas Dostalek; Helidon Nina; Petr Krivorotko; Jean-Marc Classe; Ellen Schlichting; Matilda Appelgren; Peter Paluchowski; Christine Solbach; Jens-Uwe Blohmer; Thorsten Kühn Journal: Cancers (Basel) Date: 2021-03-29 Impact factor: 6.639