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Radiologic Mapping for Targeted Axillary Dissection: Needle Biopsy to Excision.
Kyungmin Shin1, Abigail S Caudle2, Henry M Kuerer2
11 Department of Diagnostic Radiology, Breast Imaging, The University of Texas MD Anderson Cancer Center, CPB5.3200, Unit 1350, 1515 Holcombe Blvd, Houston, TX 77030.
AJR. American Journal of Roentgenology
|October 12, 2016
Summary
A new imaging-guided approach uses clip markers for targeted axillary dissection in breast cancer patients receiving neoadjuvant chemotherapy, enabling personalized and less invasive surgical management of nodal metastasis.
Area of Science:
- Oncology
- Surgical Oncology
- Breast Cancer Research
Background:
- Axillary nodal status is crucial for breast cancer staging, prognosis, and treatment decisions.
- Current trends favor minimally invasive therapeutic strategies for breast cancer management.
- Accurate staging is essential for tailoring treatment and improving patient outcomes.
Purpose of the Study:
- To evaluate the feasibility and safety of an imaging-guided, multidisciplinary approach for axillary staging.
- To enable personalized and less invasive surgical management of the axilla via targeted axillary dissection.
- To assess the utility of clip markers in guiding axillary surgery for patients with nodal metastasis.
Main Methods:
- Utilizing an imaging-guided, multidisciplinary strategy for axillary staging.
- Placing clip markers in biopsied metastatic axillary lymph nodes in patients with N1-N2 disease.
- Employing radioactive seeds for localization of the clipped node during sentinel lymph node dissection.
Main Results:
- The described approach facilitates targeted axillary dissection, focusing on the clipped metastatic node.
- This method allows for precise identification of the metastatic node, guiding surgical decisions.
- The technique supports a personalized approach to axillary surgery, potentially reducing its extent.
Conclusions:
- The imaging-guided, multidisciplinary approach is feasible and safe for axillary staging.
- Clip marker placement enables targeted axillary dissection, supporting minimally invasive breast cancer treatment.
- This strategy is critical for personalized surgical management in patients with nodal metastasis undergoing neoadjuvant chemotherapy.
