# Targeted axillary dissection using Radioguided Occult Lesion Localization technique in the clinically negative marked lymph node after neoadjuvant treatment in breast cancer patients.

**Autores:** Del Castillo A, Gomez-Modet S, Mata JM et al.
**Revista:** Eur J Surg Oncol (2023)
**PMID:** 36958951 | **PMCID:** —
**DOI:** [10.1016/j.ejso.2023.03.208](https://doi.org/10.1016/j.ejso.2023.03.208)
**Fuente:** PubMed (abstract only — full text vía DOI)

## Relevancia
Serie institucional/registro que aporta cifras de tasas de ypN0, falsos negativos de SLNB/TAD y patrones de manejo axilar tras NAC en cáncer de mama cN+.

## Abstract
To be aware of the feasibility of targeted axillary dissection (TAD) injectingTechnetium-labeled macroaggregated albumin (Tc-MAA) preoperatively into the clipped lymph node of patients with axillary complete clinical response (ycN0), after neoadjuvant chemotherapy (NAC) for breast cancer.

A retrospective observational study was performed on N1 patients with a clipped positive node and a clinically negative axilla (ycN0) after NAC in one center. The pretreatment positive lymph node was injected withTc-MAA the day before surgery and identified intraoperatively with a radioguided occult lesion localization (ROLL) technique. Patients were subjected to a TAD with the intent of identifying the clipped node and other/s sentinel nodes through a standard sentinel lymph node biopsy (SLNB).

54 patients and 55 axillary clipped nodes were included. The clip was intraoperatively encountered in every patient, accomplishing a 100% detection rate, although in one case no lymphatic tissue could be found in the intraoperative frozen section. An axillary lymph node dissection (ALND) was avoided in 62.9% of the cases (34/54).

The use of the ROLL technique is a highly valuable tool since it allows a 100% success rate in retrieving the marker (and a 98.1% rate in detecting the clipped lymph node) in ycN0 breast cancer patients.

## Acceso
Vía [DOI](https://doi.org/10.1016/j.ejso.2023.03.208) o suscripción institucional.

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*Datos de PubMed. Citar: doi 10.1016/j.ejso.2023.03.208*
