Ultrasound-guided preoperative lymph node localization for subsequent targeted axillary dissection using a tumor marker coil
Purpose To assess an ultrasound (US) - guided localization technique of pathologic lymph nodes for subsequent targeted axillary dissection (TAD) in breast cancer, particularly after neoadjuvant therapy.
Materials and Methods Until 12/2019 61 patients were identified who had undergone single or multiple US-guided marking of either one or two axillary lymph nodes with biopsy - proven or US/CT-suspected breast cancer involvement (n = 53 after neoadjuvant chemotherapy). A coil (MReye® Breast Localization Coil, Cook Medical) was used as a market introduced tumor marker. Preoperatively, US-guided wire localization of the coil was performed. Intra-operative specimen radiography was used to prove a complete marker removal.
Results So far, preoperative wire localizations were analyzed that were scheduled for 46 patients with 58 coils. Without difficulty 53 coils (91 %) could be localized. In five cases (9 %) the coil could not be identified clearly via ultrasound. Therefore, fluoroscopy was used to identify the exact location of four of the coils, providing for a US-guided wire marking of 57 coils. All implanted coils were retrieved during primary surgery, which resulted in a 100 % retrieval rate. No significant complications occurred.
Conclusion US-guided coil marking of biopsy-proven positive lymph nodes and intraoperative retrieval of these lymph nodes by US-guided preoperative wire localization of the coils is a technically feasible and safe method to enable targeted axillary dissection, particularly after neoadjuvant therapy.
24 June 2020 (online)
© Georg Thieme Verlag KG
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