Related Experiment Video
Updated: Jun 7, 2026
Single-port Non-liposuction Endoscopic Axillary Lymph Node Dissection in Breast Cancer Surgery
Published on: April 3, 2026
Targeted axillary dissection in breast cancer patients: a systematic review and meta-analysis
Mohammed N Abdelaziz1, Sagad O O Mohamed2, Mohammed Hesham Nagi3
1Faculty of Medicine, Mansoura University Hospital, Mansoura, Egypt. mohammednasser@std.mans.edu.eg.
Abstract:
Targeted axillary dissection (TAD) is an innovative approach for axillary staging in breast cancer patients with initially node-positive disease that converts to clinically node-negative status after neoadjuvant therapy. Optimal marking and localization techniques remain undetermined. This systematic review and meta-analysis searched PubMed, Scopus, Cochrane Library, and Web of Science through April 2025, including 59 observational studies on TAD (marked/clipped node removal plus sentinel lymph node biopsy) in such patients. Primary outcomes were identification rate, false-negative rate (FNR), concordance, and diagnostic accuracy. Using R software with random-effects models and logit transformation, TAD achieved a pooled identification rate of 95.1% (95% CI: 93.2%-96.5%). Pooled FNR was 6.37% (95% CI: 5.02%-8.04%; I² = 0.0%), with overall diagnostic accuracy of 94.68% (95% CI: 91.70%-96.63%). Targeted and sentinel nodes concorded in 73.34% (95% CI: 69.58%-76.79%). Subgroup analyses showed comparable performance across marking (clip, carbon, magnetic, radioactive seeds) and localization techniques (wire-guided, radioactive, magnetic, ultrasound-guided), with no significant differences. TAD offers high identification rates, low FNRs, reliable staging, and acceptable accuracy, with consistent results enabling implementation using locally available technologies.
Insights
Targeted axillary dissection (TAD) provides reliable breast cancer staging for node-positive patients after neoadjuvant therapy. This approach shows high identification rates and acceptable accuracy, supporting its clinical implementation.
Area of Science:
- Oncology
- Surgical Oncology
- Breast Cancer Research
Background:
- Neoadjuvant therapy can convert initially node-positive breast cancer patients to a clinically node-negative status.
- Accurate axillary staging is crucial for these patients, but optimal methods for targeted axillary dissection (TAD) remain unclear.
Purpose of the Study:
- To systematically review and meta-analyze the performance of targeted axillary dissection (TAD) in breast cancer patients.
- To evaluate identification rates, false-negative rates (FNR), concordance, and diagnostic accuracy of TAD.
- To compare different marking and localization techniques used in TAD.
Main Methods:
- Systematic review and meta-analysis of 59 observational studies on TAD.
- Searched PubMed, Scopus, Cochrane Library, and Web of Science databases.
- Analyzed primary outcomes including identification rate, FNR, concordance, and diagnostic accuracy using R software and random-effects models.
Main Results:
- TAD achieved a pooled identification rate of 95.1% and a pooled FNR of 6.37%.
- Overall diagnostic accuracy for TAD was 94.68%, with 73.34% concordance between targeted and sentinel nodes.
- Subgroup analyses revealed comparable performance across various marking and localization techniques, with no significant differences.
Conclusions:
- Targeted axillary dissection (TAD) demonstrates high identification rates, low FNRs, and acceptable diagnostic accuracy for axillary staging in breast cancer.
- Performance of TAD is consistent across different marking and localization methods, facilitating its implementation with available technologies.
More Related Videos
03:07Single-Port Robotic-assisted Transaxillary Breast-conserving Surgery: A Prospective, Single-arm, Non-randomized Phase IIa Clinical Trial
Published on: August 19, 2025
13:35Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024