Targeted Axillary Dissection Using Surgical Marker Navigation after Neoadjuvant Systemic Treatment in Breast Cancer Patients: A Single-Center Experience

Background: In early-stage breast cancer with initially positive axillary lymph nodes, reliable assessment of the involvement of the axilla is important because of the prognostic importance of lymph node metastases. After neoadjuvant chemotherapy (NACT), targeted axillary dissection (TAD), including sentinel lymph node biopsy and primarily involved lymph nodes, is currently regarded as the standard of care. The target lymph node must be marked using a clip/marker and later localized using a reliable guidance technique to identify the node, to avoid the indication of axillary lymph node dissection. Methods: surgical marker navigation system. Results: This consecutive case series shows that identification of the target node with surgical marker navigation is feasible and safe, with a 100% identification rate at surgery, in a population of 20 patients with histologically verified axillary lymph node involvement before NACT. Conclusion: Magnetically guided localization systems may therefore be a valid alternative to ultrasound-guided wire placement. The data highlight the practicality of the magnetically guided approach, which potentially contributes to a reduction in treatment-related morbidity by avoiding unnecessary axillary lymph node dissection.