Diagnosis of axillary metastatic disease using micro-pulse biopsy system – current status and future developments

Background:

The basis for systemic and surgical treatment decision making is a reliable assessment of axillary lymph node status. The development of axillary diagnostics undoubtly moves into the direction of non-surgfical, minimally-invasive procedures. Tissue sampling and clip-marking of radiologically metastatic and suspicious lymph nodes (iN+) in the context of conversion to yiN- is limited in certain situations by the size and location of individual lymph nodes. Automatic or semi-automatic spring-loades biopsy systems are currently being used for tissue sampling.

Methodology:

In a clinical trial of the AG Mimi (Arbeitsgemeinschaft Minimal-invasive Mammadiagnostik der Deutschen Gesellschaft für Senologie) a new biopsy system is evaluated and sonographic characteristics as well as factors indicating a challenging procedure (e.g. vicinity to blood vessel or thoracic wall, size of the lymph node) are systematically assessed and analyzed.

Results:

Newly developed biopsy modalities could improve diagnosic accuracy of minimally-invasive diagnostics in the axilla.

Outlook:

The biopsy method of an ultrasounded-guided pulsed needle insertion has been pioneered in the NeoNavia biopsy system. Paired with a novel needle design, this biopsy procedure is now being assessed in clinical practice. The main focus of current research is on axillary diagnosis. Practical clinical experience is used to further develop the system to optimize handling and implement the micro-pulse biopsy method as a multimodal platform technology.