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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Hartmann, S; Banys-Paluchowski, M; Berger, T; Ditsch, N; Stickeler, E; de, Boniface, J; Gentilini, OD; Schroth, J; Karadeniz, Cakmak, G; Rubio, IT; Gasparri, ML; Kontos, M; Bonci, EA; Niinikoski, L; Murawa, D; Kadayaprath, G; Pinto, D; Peintinger, F; Schlichting, E; Dostalek, L; Nina, H; Valiyeva, H; Vanhoeij, M; Perhavec, A; Zippel, D; Rebaza, LP; Thongvitokomarn, S; Fröhlich, S; Ruf, F; Rief, A; Wihlfahrt, K; Basali, T; Thill, M; Lux, MP; Loibl, S; Kolberg, HC; Blohmer, JU; Hahn, M; Gurleyik, MG; Porpiglia, M; Gunay, S; Zetterlund, L; Kuehn, T, , AXSANA, Study, Group.
Lost axillary markers after neoadjuvant chemotherapy in breast cancer patients - data from the prospective international AXSANA (EUBREAST 3) cohort study (NCT04373655).
Eur J Surg Oncol. 2025; 51(9): 110253 Doi: 10.1016/j.ejso.2025.110253
Web of Science PubMed FullText FullText_MUG

Co-Autor*innen der Med Uni Graz: Peintinger Florentia; Rief Angelika
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Abstract:: INTRODUCTION: Marking metastatic lymph nodes before neoadjuvant chemotherapy (NACT) has become increasingly popular in the surgical treatment of breast cancer. A variety of devices are currently in use. However, the significance of lost markers is poorly understood, and their impact on clinical decisions is unclear. MATERIALS AND METHODS: Among participants enrolled in the prospective AXSANA cohort study, those planned for target lymph node biopsy (TLNB) or targeted axillary dissection (TAD) with completed post-NACT locoregional therapy (surgery and radiotherapy) by January 21, 2025, were included. RESULTS: In 88 of 1528 patients (5.8 %), axillary markers could not successfully be removed during surgery after NACT. The lost marker rate differed depending on the marker type (metallic clip/coil 7.0 %, carbon 3.1 %, radar reflector 1.4 %, magnetic seed 0.6 %, radioactive seed 0.0 %, p < 0.001). Additional postoperative imaging was performed in 25 (28.4 %) and further surgery to remove axillary markers was performed in 6 (6.8 %) patients with lost markers. The proportion of patients undergoing axillary lymph node dissection (46.6 % versus 36.5 %, p 0.069) and axillary radiotherapy (51.1 % versus 50.2 %, p 0.748) did not differ between patients with and without lost markers. After an average follow-up of 21.8 months, axillary recurrences occurred in 3 patients (3.3 %) with and 16 patients (1.0 %) without lost markers (rate ratio 2.89, p 0.088). CONCLUSION: The loss of markers in TLNB/TAD is uncommon and significantly depends on the marking technique. Lost markers may lead to diagnostic uncertainties and additional imaging or surgical procedures.
Find related publications in this database (Keywords): Breast cancer; Target lymph node; Neoadjuvant chemotherapy; Axillary surgery; Lost marker