Keywords
breast cancer
axillary dissection
neoadjuvant systemic therapy
treatment efficacy
targeted axillary biopsy
How to Cite
Abstract
In press
Background. Optimization of surgical treatment for breast cancer is a relevant direction of modern oncologic surgery. Targeted lymph node biopsy improves staging accuracy and reduces the extent of surgery without compromising oncologic effectiveness. The integration of RECIST-based response assessment (Response Evaluation Criteria In Solid Tumors), modern imaging, clip localization, and histopathological verification allows personalization of surgical tactics.
Aim. To evaluate the effectiveness of a combined approach to locoregional control using targeted lymph node biopsy and axillary lymph node dissection in patients with primary breast cancer after neoadjuvant chemotherapy.
Materials and Methods. The study included 66 patients with primary breast cancer. The following parameters were analyzed: type of surgery, duration of operative stages, number of removed lymph nodes, detection rate of the marked node, concordance between the marked and sentinel nodes, and intraoperative characteristics. Statistical analysis was performed using Statistica 6.1 software (StatSoft, USA) and nonparametric statistical methods: median, interquartile range, and Spearman's rank correlation analysis. The work was carried out within the framework of a research project with state registration number 0122U201536.
Research Ethics. The study was conducted in accordance with the World Medical Association Declaration of Helsinki (1964–2024), approved by the local ethics committee, and informed consent was obtained from all patients.
Results. The marker was localized in axillary lymph nodes in 80.3 % (53 out of 66) of cases on preoperative imaging and was not identified in 13 cases (19.7 %). At the same time, the marker was identified in the resected surgical specimen in 93.9 % of cases, reflecting higher intraoperative detection compared to preoperative imaging. According to ultrasound data, the tumor or regional lymph nodes were visualized in 50 cases (75.8 %). Mastectomy with targeted biopsy and axillary lymph node dissection was performed in 21.0 % of patients, while breast-conserving surgeries were performed in 79.0 %. The high marker identification rate (93.9 %) confirmed the technical reliability of the TAD (Targeted Axillary Dissection) technique.
Conclusions. The combination of targeted biopsy and controlled axillary lymph node dissection provides effective locoregional control, facilitates surgical de-escalation, and reduces operative trauma without compromising oncologic radicality.
Keywords: oncology, breast cancer, axillary dissection, neoadjuvant systemic therapy, treatment efficacy, targeted axillary biopsy.
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