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Related Experiment Video

Updated: Sep 13, 2025

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
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Initial Insights into Targeted Axillary Dissection Post-Neoadjuvant Therapy in Node-Positive Breast Cancer: A Pilot

A Aosmali1, M Nafie2, A Nafie3

  • 1MRCS, MD, and Lecturer of General Surgery, Faculty of Medicine, Ain Shams University and Kings college Hospital, England.

La Clinica Terapeutica
|July 29, 2025
PubMed
Summary

Targeted axillary dissection improves breast cancer staging accuracy by guiding surgical removal of clipped lymph nodes. This technique reduces the false-negative rate of sentinel lymph node biopsy in patients with node-positive breast cancer receiving neoadjuvant chemotherapy.

Keywords:
AxillaryBreast CancerPost-Neoadjuvant Therapy

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Breast Cancer Research

Background:

  • Breast cancer is a leading global malignancy and cause of cancer death in women.
  • Accurate axillary lymph node (ALN) staging is crucial for breast cancer treatment.
  • Sentinel lymph node biopsy (SLNB) has largely replaced axillary lymph node dissection for early-stage patients.

Purpose of the Study:

  • To evaluate the accuracy of targeted axillary resection in breast cancer patients.
  • To determine if preoperative clipping and targeted removal of ALNs improve nodal staging accuracy.

Main Methods:

  • A pilot interventional study involving 30 patients with clinical node-positive breast cancer undergoing neoadjuvant chemotherapy (NACT).
  • Preoperative clipping of axillary lymph nodes followed by sentinel lymph node biopsy (SLNB).

Main Results:

  • Of 30 patients, 24 had clipped ALNs successfully stained with patent blue dye.
  • SLNB failed to detect clipped ALNs in 5 patients, resulting in a 17.2% false-negative rate (FNR).
  • Targeted axillary dissection demonstrated potential to decrease the FNR of SLNB.

Conclusions:

  • Targeted axillary dissection is a viable approach for managing clinically N1 breast cancer patients who become node-negative (N0) after NACT.
  • Preoperative guide wire localization of clipped nodes significantly improves identification rates and reduces the FNR of SLNB.