Radar reflector guided axillary surgery in node positive breast cancer patients

Expert Rev Med Devices. 2022 Oct;19(10):791-795. doi: 10.1080/17434440.2022.2139177. Epub 2022 Nov 8.

Abstract

Introduction: In patients with non-palpable breast cancer, the availability of wireless localization techniques facilitates removal of the target lesion. One such technique uses a radar reflector for localization (RRL). This study evaluates the feasibility and effectiveness of RRL to guide excision of axillary lymph nodes in patients with node-positive breast cancer.

Methods: Our Breast Cancer Database was queried for patients diagnosed with breast cancer, between 5/2017 and 10/2021, who underwent preoperative placement of a radar reflector into a biopsy proven axillary lymph node. Clinicopathologic data were reported using descriptive statistics.

Results: Twenty patients underwent preoperative placement of a radar reflector into the axilla. Intraoperatively, the clip and radar reflector were successfully removed in all patients. Among the 10 patients treated with NAC, 5 patients achieved an axillary pathologic complete response (pCR) and were spared a complete axillary lymph node dissection (cALND). Among the entire cohort, RRL resulted in a 53% reduction in the number of lymph nodes removed.

Conclusions: Wireless localization of axillary lymph nodes is safe and feasible. The technique ensures excision of biopsy proven positive axillary lymph nodes and enables a targeted approach to assessing the axilla, both in the setting of NAC and upfront surgery.

Keywords: Breast cancer; SAVI SCOUT; axillary lymph node dissection; axillary surgery; neoadjuvant chemotherapy; radar-reflector guided localization; targeted axillary dissection.

MeSH terms

  • Axilla / pathology
  • Breast Neoplasms* / diagnosis
  • Female
  • Humans
  • Lymph Node Excision / methods
  • Lymph Nodes / pathology
  • Lymph Nodes / surgery
  • Lymphatic Metastasis
  • Neoadjuvant Therapy
  • Neoplasm Staging
  • Radar
  • Sentinel Lymph Node Biopsy / methods