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Radioguided Surgery and Axillary Management in Breast Cancer: From Molecular Imaging to 3D Navigation Toward
John Orozco Cortés1, Marta Tapia2, Jorge Sabater Sancho3
1Department of Nuclear Medicine, Hospital Universitario Dr. Peset, FISABIO, 46017 Valencia, Spain.
Life (Basel, Switzerland)
|July 28, 2026
Summary
Radioguided surgery enhances breast cancer care by improving accuracy in lesion localization and axillary management, especially after neoadjuvant therapy. Emerging technologies and AI further personalize treatment, reducing patient morbidity.
Area of Science:
- Oncology
- Surgical Innovation
- Medical Imaging
Background:
- Radioguided surgery is crucial in modern breast cancer care, balancing minimally invasive techniques with oncologic safety.
- Neoadjuvant systemic therapy significantly impacts surgical decision-making by altering breast and nodal anatomy.
- Personalized treatment pathways are increasingly adopted in breast cancer management.
Purpose of the Study:
- To review current practices and recent advancements in radioguided breast and axillary surgery.
- To explore the integration of molecular imaging and novel technologies in surgical workflows.
- To discuss the role of radioguided techniques in personalized breast cancer treatment.
Main Methods:
- Narrative review of established and emerging radioguided surgical techniques.
- Discussion of sentinel lymph node strategies and de-escalation concepts like targeted axillary dissection (TAD).
- Examination of localization methods (e.g., radioactive seeds) and advanced imaging (SPECT, PET/CT).
Main Results:
- Radioguided techniques ensure procedural accuracy despite anatomical changes from neoadjuvant therapy.
- Targeted axillary dissection (TAD) and selective node removal are effective de-escalation strategies.
- Advanced technologies like portable SPECT and intraoperative PET/CT improve precision and margin assessment.
Conclusions:
- Radioguided surgery, enhanced by molecular imaging and 3D guidance, personalizes breast and axillary management.
- Emerging technologies and AI integration optimize surgical workflows and decision support.
- These advancements aim to improve patient outcomes and reduce treatment-related morbidity.
