Purpose To assess an ultrasound (US) - guided localization technique of pathologic lymph
nodes for subsequent targeted axillary dissection (TAD) in breast cancer, particularly
after neoadjuvant therapy.
Materials and Methods Until 12/2019 61 patients were identified who had undergone single or multiple US-guided
marking of either one or two axillary lymph nodes with biopsy - proven or US/CT-suspected
breast cancer involvement (n = 53 after neoadjuvant chemotherapy). A coil (MReye® Breast Localization Coil, Cook Medical) was used as a market introduced tumor marker.
Preoperatively, US-guided wire localization of the coil was performed. Intra-operative
specimen radiography was used to prove a complete marker removal.
Results So far, preoperative wire localizations were analyzed that were scheduled for 46
patients with 58 coils. Without difficulty 53 coils (91 %) could be localized. In
five cases (9 %) the coil could not be identified clearly via ultrasound. Therefore,
fluoroscopy was used to identify the exact location of four of the coils, providing
for a US-guided wire marking of 57 coils. All implanted coils were retrieved during
primary surgery, which resulted in a 100 % retrieval rate. No significant complications
occurred.
Conclusion US-guided coil marking of biopsy-proven positive lymph nodes and intraoperative retrieval
of these lymph nodes by US-guided preoperative wire localization of the coils is a
technically feasible and safe method to enable targeted axillary dissection, particularly
after neoadjuvant therapy.
