4th Istanbul International Breast Cancer Conference, İstanbul, Turkey, 17 - 18 October 2020, pp.6-7
Localizing the clipped tumor and clipped node in patients with node-positive breast cancer treated with neoadjuvant chemotherapy: single center experience
Aim: Clip placement into primary breast tumor and positive node in patients with breast cancer treated with neoadjuvant chemotherapy (NAC) allows conservative surgery. Our aim was to evaluate the performance of preoperative imaging guided localization of clipped tumor and clipped axillary lymph node.
Methods: Institutional ethical committee approval was obtained. In last two years, all breast cancer patients with biopsy positive breast tumor and axillary lymph node clipped at the time of diagnosis who underwent NAC followed by surgery were retrospectively evaluated.
Results: Data of 67 female breast cancer patient (67 clipped breast tumor, and 57 clipped node) were retrospectively evaluated. After chemotherapy, clipped tumor was easily localized with ultrasonography (US) or mammography guidance. All breast clip localization procedures were done successfully (Fig.1). Of the 57 clipped nodes, 45 (79%) were localized with US guidance successfully. In 12 patients, clipped node was not visible by sonography. Computed tomography (CT) guided wire localization were performed as an alternative localization method. Remaining 12 US-negative clipped nodes were localized successfully with CT guidance (Fig.2). Removal of clipped tumor and clipped node were confirmed with specimen radiography.
Discussion: In this study, clipped breast tumor identification rate was 100% with US or mammography. Clipped node identification rate was 79% with US. Ultrasonography is not a perfect method for clipped node localization. Computed tomography is a useful alternative imaging tool for identification and localization of sonographically nonvisible clipped nodes.
Key Words: breast cancer, imaging-guided wire localization, lymph node metastasis, neo-adjuvant chemotherapy