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Prospective Registry Trial Assessing the Use of Magnetic Seeds to Locate Clipped Nodes After Neoadjuvant Chemotherapy for Breast Cancer Patients

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Targeted axillary dissection (TAD) involves locating and removing both clipped nodes and sentinel nodes for assessment of the axillary response to neoadjuvant chemotherapy (NAC) by clinically node-positive breast cancer patients. Initial reports described radioactive seeds used for localization, which makes the technique difficult to implement in some settings. This trial was performed to determine whether magnetic seeds can be used to locate clipped axillary lymph nodes for removal.

Methods

This prospective registry trial enrolled patients who had biopsy-proven node-positive disease with a clip placed in the node and treatment with NAC. A magnetic seed was placed under ultrasound guidance in the clipped node after NAC. All the patients underwent TAD.

Results

Magnetic seeds were placed in 50 patients by 17 breast radiologists. All the patients had successful seed placement at the first attempt (mean time for localization was 6.1 min; range 1–30 min). The final position of the magnetic seed was within the node (n = 44, 88%), in the cortex (n = 3, 6%), less than 3 mm from the node (n = 2, 4%), or by the clip when the node could not be adequately visualized (n = 1, 2%). The magnetic seed was retrieved at surgery from all the patients. In 49 (98%) of the 50 cases, the clip and magnetic seed were retrieved from the same node. Surgeons rated the transcutaneous and intraoperative localization as easy for 43 (86%) of the 50 cases. No device-related adverse events occurred.

Conclusions

Localization and selective removal of clipped nodes can be accomplished safely and effectively using magnetic seeds.

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Acknowledgments

This research was supported by an NIH Cancer Center support Grant (CA16672) and the MD Anderson High Impact Research Support Program (ASC).

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Correspondence to Abigail S. Caudle MD, MS.

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Disclosure

The institution of Marion E. Scoggins, Henry M. Kuerer, Savitri Krishnamurthy, Wei T. Yang, Aysegul A. Sahin,Yu Shen, Heather Lin, Isabelle Bedrosian, Deanna L. Lane, Kelly K. Hunt, Abigail S. Caudle has received research support from Endomagnetics, Lumicell, and OncoNano. Endomagnetics did not provide research support for this protocol. Endomagnetics has provided travel for Abigail S. Caudle for a speaking engagement. Kelly K. Hunt serves on the Medical Advosry Board of Armada Health and Merck & Co. The remaining authors have no conflicts of interest.

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Simons, J.M., Scoggins, M.E., Kuerer, H.M. et al. Prospective Registry Trial Assessing the Use of Magnetic Seeds to Locate Clipped Nodes After Neoadjuvant Chemotherapy for Breast Cancer Patients. Ann Surg Oncol 28, 4277–4283 (2021). https://doi.org/10.1245/s10434-020-09542-y

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  • DOI: https://doi.org/10.1245/s10434-020-09542-y

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