Targeted Axillary Dissection Using Surgical Marker Navigation after Neoadjuvant Systemic Treatment in Breast Cancer Patients - A Single-Center Experience

Sep 29, 2026

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Early-stage breast cancer with initially positive axillary lymph nodes requires reliable assessment of axillary involvement due to the prognostic role of lymph node metastases. After neoadjuvant chemotherapy, targeted axillary dissection (TAD) is considered standard, but the target node must be marked and later localized reliably. This retrospective single-center study evaluated the Sirius Pintuition GPSDetect surgical marker navigation system for efficacy and safety. Identification was feasible and safe, achieving a 100% intraoperative identification rate in 20 patients with histologically verified involvement before NACT. Magnetically guided localization may offer an alternative to ultrasound-guided wire placement.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Background

Methods

Results

Conclusion

Introduction

Role of axillary assessment and SLN biopsy after NACT

Rationale for targeted axillary dissection (TAD)

Guidance techniques for localizing marked nodes

Breast Care Research Article Breast Care 2025;20:57–64 DOI: 10.1159/000541704 Received: August 19, 2024 Accepted: September 28, 2024 Published online: January 7, 2025 Targeted Axillary Dissection Using Surgical Marker Navigation after Neoadjuvant Systemic Treatment in Breast Cancer Patients: A Single-Center Experience Daniel Eglea Christine Brunner a Magdalena Ritter a Verena Wiesera Katharina Knolla Birgit Amort b Afshin Soleimanc Heidelinde Fiegla Christian Martha Carmen Albertinia Rupert Bartsch d aDepartment of Obstetrics and Gynaecology, Breast Cancer Center Tirol, Medical University of Innsbruck, Innsbruck, Austria; bDepartment of Radiology, Medical University of Innsbruck, Innsbruck, Austria; cINNPATH, Institute of Pathology, Tirol Kliniken Innsbruck, Innsbruck, Austria; dDivision of Oncology, Department of Medicine, Medical University of Vienna, Vienna, Austria Keywords Axilla · Chemotherapy · Imaging technique · Magnetics · Margins of excision · Neoplasm · Neoplasm grading · Therapy Abstract Background: In early-stage breast cancer with initially positive axillary lymph nodes, reliable assessment of the involvement of the axilla is important because of the prognostic importance of lymph node metastases. After neoadjuvant chemotherapy (NACT), targeted axillary dissection (TAD), including sentinel lymph node biopsy and primarily involved lymph nodes, is currently regarded asthe standard of care. The target lymph node must be marked using a clip/marker and later localized using a reliable guidance technique to identify the node, to avoid the indication of axillary lymph node dissection. Methods: The present study aimed to evaluate retrospective data collected from April 25, 2022, until March 30, 2023, on a consecutive series of patients, to determine the efﬁcacyand safety of using the Sirius Pintuition GPSDetect™ surgical marker navigation system. Results: This consecutive case series shows that identiﬁcation of the target node with surgical marker navigation is feasible and safe, with a 100% identiﬁcation rate at surgery, in a population of 20 patients with histologically veriﬁed axillary lymph node involvement before NACT. Conclusion: Magnetically guided localization systems may therefore be a valid alternative to ultrasound-guided wire placement. The data highlight the practicality of the magnetically guided approach, which potentially contributes to a reduction in treatment-related morbidity by avoiding unnecessary axillary lymph node dissection. © 2025 The Author(s) . Published by S. Karger AG, Basel Introduction Neoadjuvant chemotherapy (NACT) is regarded as a standard treatment approach in patients with stage II/ III human epidermal growth factor receptor 2 (HER2) -positive and triple-negative breast cancer. The use of NACT allows for downsizing and downstaging of the disease, in vivo sensitivity testing, and responseadapted tailoring of post-neoadjuvant treatment. In hormone receptor (HR)-positive/HER2-negative (luminal) disease, NACT can be used in aggressive cases of the disease requiring adjuvant chemotherapy, but it is usually preferred in cases of more advanced local [karger@karger.com](karger@karger.com)[ ](karger@karger.com)[www.karger.com/brc](www.karger.com/brc) © 2025 The Author(s) . Published by S. Karger AG, Basel This article is licensed under the Creative Commons AttributionNonCommercial4.0International License(CC BY-NC)([http://www](http://www). [karger.com/Services/OpenAccessLicense](karger.com/Services/OpenAccessLicense)). Usage and distribution for commercial purposes requires written permission. Correspondence to: Daniel Egle, [daniel.egle](daniel.egle@ tirol-kliniken.at)[@](daniel.egle@ tirol-kliniken.at)[ tirol-kliniken.at](daniel.egle@ tirol-kliniken.at) disease. While the introduction of neoadjuvant treatment strategies, including chemotherapy and targeted agents, has improved patient outcomes, local downsizing and downstaging has resulted in

FAQs

Why is reliable assessment of axillary involvement critical in early-stage breast cancer?

Lymph node metastases remain a key prognostic factor, so accurate assessment of axillary involvement is needed for appropriate treatment decisions.

What is the main objective of the study described in the abstract?

To evaluate, using retrospective data from April 25, 2022 to March 30, 2023, the efficacy and safety of the Sirius Pintuition GPSDetect surgical marker navigation system for targeted axillary dissection after NACT.

What were the identification results and safety implication reported?

The study reports feasible and safe identification of the target node, with a 100% intraoperative identification rate in 20 patients with histologically verified axillary lymph node involvement before NACT.

Sep 29, 2026

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