Lost Axillary Markers After Neoadjuvant Chemotherapy in Breast Cancer Patients - Data From the Prospective International AXSANA (EUBREAST 3) Cohort Study (NCT04373655)
| dc.authorscopusid | 48662033900 | |
| dc.authorscopusid | 56596688600 | |
| dc.authorscopusid | 59565017500 | |
| dc.authorscopusid | 55937173700 | |
| dc.authorscopusid | 55990433800 | |
| dc.authorscopusid | 23098994700 | |
| dc.authorscopusid | 35488958300 | |
| dc.contributor.author | Hartmann, S. | |
| dc.contributor.author | Banys-Paluchowski, M. | |
| dc.contributor.author | Berger, T. | |
| dc.contributor.author | Ditsch, N. | |
| dc.contributor.author | Stickeler, E. | |
| dc.contributor.author | de Boniface, J. | |
| dc.contributor.author | Nowecki, Z.I. | |
| dc.date.accessioned | 2025-07-15T19:05:07Z | |
| dc.date.available | 2025-07-15T19:05:07Z | |
| dc.date.issued | 2025 | |
| dc.department | Okan University | en_US |
| dc.department-temp | [Hartmann S.] Department of Gynecology and Obstetrics, University Hospital Rostock, Rostock, Germany; [Banys-Paluchowski M.] Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany; [Berger T.] Department of Gynecology and Obstetrics, Müritz-Klinikum Waren, Waren, Germany; [Ditsch N.] Gynecology, Operative and Conservative Senology, Faculty of Medicine, University of Augsburg and CCC WERA, Augsburg, Germany, Bavarian Cancer Research Center (BZKF), Study Group Breast Cancer, Erlangen, Germany; [Stickeler E.] Department of Gynecology and Obstetrics, University Hospital Aachen, Aachen, Germany; [de Boniface J.] Department of Surgery, Breast Center, Capio St. Göran's Hospital, Stockholm, Sweden, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; [Gentilini O.D.] Università Vita-salute San Raffaele, Milano, Italy, IRCCS Ospedale San Raffaele, Milano, Italy; [Schroth J.] Brandenburg Medical School Theodor Fontane, Institute for Biostatistics and Registry Research, Neuruppin, Germany; [Karadeniz Cakmak G.] Zonguldak BEUN the School of Medicine, General Surgery Department, Breast and Endocrine Unit, Zonguldak, Turkey; [Rubio I.T.] Breast Surgical Unit, Clínica Universidad de Navarra, CCUN, Madrid, Spain; [Gasparri M.L.] Department of Gynecology and Obstetrics, Ente Ospedaliero Cantonale, Ospedale Regionale di Lugano, Lugano, Switzerland, University of the Italian Switzerland (USI), Faculty of Biomedicine, Lugano, Switzerland; [Kontos M.] Department of Surgery, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece; [Bonci E.-A.] Department of Surgical Oncology, “Prof. Dr. Ion Chiricuță” Institute of Oncology, Cluj-Napoca, Romania, Department of Oncological Surgery and Gynecological Oncology, “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania; [Niinikoski L.] Breast Surgery Unit, Comprehensive Cancer Center, Helsinki University Hospital, University of Helsinki, Finland; [Murawa D.] Department of General Surgery and Surgical Oncology, Collegium Medicum, University of Zielona Góra, Zielona Góra, Poland; [Kadayaprath G.] MAX Hospital, Patparganj, New Delhi, India; [Pinto D.] Breast Unit, Champalimaud Clinical Center, Champalimaud Foundation, Lisboa, Portugal; [Peintinger F.] Institute of Pathology, Medical University of Graz, Graz, Austria, Department of Gynecology and Obstetrics, Medical University of Graz, Graz, Austria; [Schlichting E.] Department of Oncology, Oslo University Hospital, Norway; [Dostalek L.] Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic; [Nina H.] Department of Surgery, Oncology Hospital, Tirana, Albania; [Valiyeva H.] Oncologic Clinic of Azerbaijan Medical University, Baku, Azerbaijan; [Vanhoeij M.] Universitair Ziekenhuis Brussel, Brussel, Belgium; [Perhavec A.] Institute of Oncology Ljubljana, Ljubljana, Slovenia; [Zippel D.] Surgical Oncology Unit Chaim Sheba Medical Centre, Ramat Gan, Israel; [Rebaza L.P.] Breast Surgery, Oncosalud, Lima, Peru; [Thongvitokomarn S.] Queen Sirikit Centre for Breast Cancer, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; [Fröhlich S.] Department of Gynecology and Obstetrics, University Hospital Rostock, Rostock, Germany; [Ruf F.] Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany; [Rief A.] Department of Gynecology and Obstetrics, Medical University of Graz, Graz, Austria; [Wihlfahrt K.] Practice for Gynecology and Obstetrics Wihlfahrt, Kiel, Germany; [Basali T.] Department of Gynecology and Obstetrics, Klinikum Stuttgart - Olgahospital, Stuttgart, Germany; [Thill M.] Department of Gynecology and Gynecological Oncology, AGAPLESION Markus Krankenhaus, Frankfurt am Main, Germany; [Lux M.P.] Department of Gynecology and Obstetrics, Frauenklinik St. Louise, Frauenklinik St. Josefs-Krankenhaus, St. Vincenz Kliniken, Paderborn, Salzkotten, Paderborn, Germany; [Loibl S.] German Breast Group, Neu-Isenburg, Germany, Centre for Haematology and Oncology Bethanien, Frankfurt, Germany; [Kolberg H.-C.] Department of Gynecology and Obstetrics, Marienhospital Bottrop, Bottrop, Germany; [Blohmer J.-U.] Department of Gynecology and Breast Center, Charité-Universitätsmedizin, Berlin, Germany; [Hahn M.] Department of Gynecology and Obstetrics, University Hospital Tübingen, Tübingen, Germany; [Gurleyik M.G.] Ministry of Health Istanbul Provincial Health Directorate Istanbul Haydarpasa Numune Research and Training Hospital, Istanbul, Turkey; [Porpiglia M.] Breast Unit S. Anna Hospital, Torino, Italy; [Gunay S.] Breast Surgery Department, Okan University Faculty of Medicine, General Surgery Clinic, Istanbul, Turkey; [Zetterlund L.] Department of Surgery, Breast Center, Capio St. Göran's Hospital, Stockholm, Sweden, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; [Kuehn T.] Department of Gynecology and Obstetrics, University of Ulm, Germany, Breast Cancer Center, Die Filderklinik, Filderstadt, Germany; Kolacinska-Wow A.; Silva A.; Fancellu A.; Hein A.; Miller A.; Thodas A.; Cruz A.I.; Musina A.-M.; Fleuster A.; Stefek A.; Putz A.; Lorek A.; Kleine-Tebbe A.; Smeets A.; Madej-Mierzwa A.; Bachmann A.; Lebeau A.; Lebrecht A.; Nixdorf A.; Grasso A.; Cordoba A.C.; Marano A.; Madrona A.P.; Goel A.K.; Sezer A.; Kothari A.; Gatzweiler A.; Leite B.C.; Schlesinger B.; Adamczyk B.; Janke B.; Lex B.; Sezen B.A.; Königs-El-Amrawy B.; Cipolla C.; Paschold C.; Schulte-Tiwisinia C.; Nestle-Krämling C.; Ugur C.M.; Yilmaz C.; Schindlbeck C.; Ankel C.; Solbach C.; Zeder-Goess C.; Anthuber C.; Großmann C.; Mayr C.; Scholz C.; Uras C.; Maurer C.; Müller C.; Neumann C.; Meisel C.; Peternell C.; Fuhljahn C.; Kühn C.; Langanke D.; De Tullio D.; Dieterle D.; Rezek D.; Bolla D.; Müller D.J.; Mink D.; Watermann D.; Fischer D.; Simon E.; von Abel E.; Ignatiadou E.; Shaari E.; Faust E.; Keil E.; Villa E.B.; Esposito E.; Schmidt E.; Klein E.; Corsi F.; Bacelar F.; Ebner F.; Guerini F.; Beldermann F.; Bilow F.; Thele F.; Fromm F.F.; Federspiel F.K.; Wärnberg F.; Feisel-Schwickardi G.; Kaltenecker G.; Stalzer G.; Franceschini G.; Tazzioli G.; Armatura G.; Xepapadakis G.; Nia H.H.; Karanlik H.; Skerjven H.K.; Eichler H.; Heidegger H.; Bekes I.; Bauerfeind I.; Thalmann I.; Buck I.; Natasiopoulos I.; Lerena I.C.; Utz-Billing I.; Himsl I.; Palatty J.; Kosse J.; Schnabel J.; Seldte J.-P.; Kruse J.-P.; Leitsmann J.; Wagner J.; Rom J.; Czihak J.; Lecht J.; Lehmann J.; Sanchez-Mendez J.I.; Fougo J.L.; Farthmann J.; Schuster J.; Lefarth J.; Wimmer-Freys K.; Chrobak-Kasprzyk K.; Aßmann K.; Jursik K.; Engelken K.; Roth K.; Hilmer K.; Ramaker K.; Winkler K.; Pankert K.; Unterrieder K.; Ahsberg K.; Freese K.; Scheerer K.; Bauer L.; Brandt L.-K.; Johnsen L.; Adwall L.; Steinhilper L.; Melnichuk L.; Lorente L.L.; Dogan L.; Ugurlu M.U.; Sanchez Barron M.T.; Smidt M.; Hofmann M.; Hufnagel M.; Sciamannini M.; Santos M.; Mangold M.; Taffurelli M.; Paul M.; Hansen M.H.; Höing M.; Keller M.; Walcher M.; D'Aiuto M.; Busani M.; Frank M.; Gülcelik M.A.; Berghorn M.; Burkhardt M.; Eichbaum M.; Hauptmann M.; Schrauder M.; Untch M.; Weigel M.; Kühn N.; Ruyssers N.; Krawczyk N.; Deuerling N.; Cabioglu N.; Rocco N.; Stahl N.; Bangemann N.; Argudo N.; Tomé O.; Agcaoglu O.; Diem P.; Dall P.; Diebold P.; Fehr P.; Bolkenius P.; Pluta P.; Völker R.; Malterling R.R.; Buss-Steidle R.; Felberbaum R.; Berger R.; Rodriguez R.; Iosifidou R.; Oom R.; Andrés-Luna R.; Lemster S.; Riemer S.; Schmatloch S.; Rauen S.; Wetzig S.; Majid S.; Gurdal S.O.; Perez S.; Mattes S.; Michieletto S.; Ovalle S.C.; Kommos S.; Lukic S.; Renner S.; Liebers S.; Hasmüller S.; Seitz S.; Ribeiro S.P.; Albrecht S.; Barrot S.; Bucher S.; Kraudelt S.; Peschel S.; Grasshoff S.-T.; Hadar T.; Abraham T.; Wanik T.; Salazar T.C.; Pursche T.; Erbes T.; Hildebrandt T.; Noesselt T.; Papathemelis T.; Lantzsch T.; Nowikiewicz T.; Reimer T.; Ivanov T.; Denison U.; Makowiec U.; Scholz U.; Fenske U.; Felten U.; Albert U.-S.; Bounous V.E.; Venizelos V.; Vural V.; Bjelic-Radisic V.; Hagen V.; Soos V.; Hanf V.; Ruhwedel W.; Heyl W.; Seifert W.; Sidiropoulou Z.; Nowecki Z.I. | en_US |
| dc.description.abstract | Introduction: Marking metastatic lymph nodes before neoadjuvant chemotherapy (NACT) has become increasingly popular in the surgical treatment of breast cancer. A variety of devices are currently in use. However, the significance of lost markers is poorly understood, and their impact on clinical decisions is unclear. Materials and methods: Among participants enrolled in the prospective AXSANA cohort study, those planned for target lymph node biopsy (TLNB) or targeted axillary dissection (TAD) with completed post-NACT locoregional therapy (surgery and radiotherapy) by January 21, 2025, were included. Results: In 88 of 1528 patients (5.8 %), axillary markers could not successfully be removed during surgery after NACT. The lost marker rate differed depending on the marker type (metallic clip/coil 7.0 %, carbon 3.1 %, radar reflector 1.4 %, magnetic seed 0.6 %, radioactive seed 0.0 %, p < 0.001). Additional postoperative imaging was performed in 25 (28.4 %) and further surgery to remove axillary markers was performed in 6 (6.8 %) patients with lost markers. The proportion of patients undergoing axillary lymph node dissection (46.6 % versus 36.5 %, p 0.069) and axillary radiotherapy (51.1 % versus 50.2 %, p 0.748) did not differ between patients with and without lost markers. After an average follow-up of 21.8 months, axillary recurrences occurred in 3 patients (3.3 %) with and 16 patients (1.0 %) without lost markers (rate ratio 2.89, p 0.088). Conclusion: The loss of markers in TLNB/TAD is uncommon and significantly depends on the marking technique. Lost markers may lead to diagnostic uncertainties and additional imaging or surgical procedures. © 2025 The Authors | en_US |
| dc.description.sponsorship | German Breast Group Forschungs GmbH; Ehmann Foundation Savognin , Eugen and Irmgard Hahn Foundation; European Breast Cancer Research Association of Surgical Trialists; Nord-Ostdeutsche Gesellschaft für Gynäkologische Onkologie; Arbeitsgemeinschaft für ästhetische; Merit Medical Systems; EndoMag; Claudia von Schilling Foundation for Breast Cancer Research; Ehmann Foundation Savognin, Eugen and Irmgard Hahn Foundation; Merit Medical; AWOgyn; EUBREAST ETS, (AGO-B-053) | en_US |
| dc.identifier.doi | 10.1016/j.ejso.2025.110253 | |
| dc.identifier.issn | 0748-7983 | |
| dc.identifier.issue | 9 | en_US |
| dc.identifier.scopus | 2-s2.0-105009151642 | |
| dc.identifier.scopusquality | Q2 | |
| dc.identifier.uri | https://doi.org/10.1016/j.ejso.2025.110253 | |
| dc.identifier.uri | https://hdl.handle.net/20.500.14517/8115 | |
| dc.identifier.volume | 51 | en_US |
| dc.identifier.wosquality | N/A | |
| dc.language.iso | en | en_US |
| dc.publisher | W.B. Saunders Ltd | en_US |
| dc.relation.ispartof | European Journal of Surgical Oncology | en_US |
| dc.relation.publicationcategory | Makale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı | en_US |
| dc.rights | info:eu-repo/semantics/closedAccess | en_US |
| dc.subject | Axillary Surgery | en_US |
| dc.subject | Breast Cancer | en_US |
| dc.subject | Lost Marker | en_US |
| dc.subject | Neoadjuvant Chemotherapy | en_US |
| dc.subject | Target Lymph Node | en_US |
| dc.title | Lost Axillary Markers After Neoadjuvant Chemotherapy in Breast Cancer Patients - Data From the Prospective International AXSANA (EUBREAST 3) Cohort Study (NCT04373655) | en_US |
| dc.type | Article | en_US |