ASO Author Reflections: Ultrasound-Guided Restaging and Localization of Axillary Lymph Nodes After Neoadjuvant Chemotherapy

Excerpt

Less invasive approaches for axillary surgery are being increasingly considered for breast cancer patients undergoing neoadjuvant chemotherapy (NAC), which reduce tumor burden in the axilla. Current trials have demonstrated the results of sentinel lymph node biopsy (SLNB) after NAC; however, variable identification rates of the sentinel node and false-negative rates of SLNB have been reported as drawbacks.1^,2 To overcome these limitations, previous studies have suggested techniques to localize the metastatic nodes.3^,4 These techniques used specialized devices (radioactive seeds) to localize the nodes and were based on initial staging. However, limited research has been conducted to evaluate the value of ultrasound (US) restaging (after NAC) and the value of the tattooing technique for suspicious nodes at US restaging, using activated charcoal, which is convenient to use and easily visualized intraoperatively. This study was performed to review our experience with US-guided localization of nodes using activated charcoal for guidance of axillary surgery after NAC in clinically node-positive breast cancer patients. …