Applicability of magnetic seeds for target lymph node biopsy after neoadjuvant chemotherapy in initially node-positive breast cancer patients: data from the AXSANA study

Steffi Hartmann*, Maggie Banys-Paluchowski, Elmar Stickeler, Jana de Boniface, Oreste Davide Gentilini, Michalis Kontos, Stephan Seitz, Gabriele Kaltenecker, Fredrik Wärnberg, Linda Holmstrand Zetterlund, Hans Christian Kolberg, Sarah Fröhlich, Thorsten Kühn

*Corresponding author for this work

Abstract

Purpose: Currently, various techniques are available to mark and selectively remove initially suspicious axillary lymph nodes (target lymph nodes, TLNs) in breast cancer patients receiving neoadjuvant chemotherapy (NACT). To date, limited data are available on whether the use of magnetic seeds (MS) is suitable for localizing TLNs. This study aimed to investigate the feasibility of MS in patients undergoing target lymph node biopsy (TLNB) or targeted axillary dissection (TAD) after NACT. Methods: Prospective data from the ongoing multicentric AXSANA study were extracted from selected patients in whom the TLN had been marked with an MS before NACT and who were enrolled from June 2020 to June 2023. The endpoints of the analysis were the detection rate, the rate of lost markers, and the potential impairment on magnetic resonance imaging (MRI) assessment. Results: In 187 patients from 27 study sites in seven countries, MS were placed into the TLN before NACT. In 151 of these, post-NACT surgery had been completed at the time of analysis. In 146 patients (96.0%), a TLN could successfully be detected. In three patients, the seed was removed but no lymphoid tissue was detected on histopathology. The rate of lost markers was 1.2% (2 out of 164 MS). In 15 out of 151 patients (9.9%), MRI assessment was reported to be compromised by MS placement. Conclusion: MS show excellent applicability for TLNB/TAD when inserted before NACT with a high DR and a low rate of lost markers. Axillary MS can impair MRI assessment of the breast. Trial registration number: NCT04373655 (date of registration May 4, 2020).

Original languageEnglish
JournalBreast Cancer Research and Treatment
Volume202
Issue number3
Pages (from-to)497-504
Number of pages8
ISSN0167-6806
DOIs
Publication statusPublished - 12.2023

Research Areas and Centers

  • Research Area: Luebeck Integrated Oncology Network (LION)
  • Centers: University Cancer Center Schleswig-Holstein (UCCSH)

DFG Research Classification Scheme

  • 205-14 Haematology, Oncology
  • 205-21 Gynaecology and Obstetrics

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