Abstract
Purpose
To be aware of the feasibility of targeted axillary dissection (TAD) injecting 99mTechnetium-labeled macroaggregated albumin (99mTc-MAA) preoperatively into the clipped lymph node of patients with axillary complete
clinical response (ycN0), after neoadjuvant chemotherapy (NAC) for breast cancer.
Patients and methods
A retrospective observational study was performed on N1 patients with a clipped positive
node and a clinically negative axilla (ycN0) after NAC in one center. The pretreatment
positive lymph node was injected with 99mTc-MAA the day before surgery and identified intraoperatively with a radioguided occult
lesion localization (ROLL) technique. Patients were subjected to a TAD with the intent
of identifying the clipped node and other/s sentinel nodes through a standard sentinel
lymph node biopsy (SLNB).
Results
54 patients and 55 axillary clipped nodes were included. The clip was intraoperatively
encountered in every patient, accomplishing a 100% detection rate, although in one
case no lymphatic tissue could be found in the intraoperative frozen section. An axillary
lymph node dissection (ALND) was avoided in 62.9% of the cases (34/54).
Conclusion
The use of the ROLL technique is a highly valuable tool since it allows a 100% success
rate in retrieving the marker (and a 98.1% rate in detecting the clipped lymph node)
in ycN0 breast cancer patients.
Keywords
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Article info
Publication history
Published online: March 09, 2023
Accepted:
March 9,
2023
Received in revised form:
December 27,
2022
Received:
November 4,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
