title: Radiologic Mapping for Targeted Axillary Dissection: Needle Biopsy to Excision.
abstract: OBJECTIVE
  The purpose of this article is to describe the feasibility and safety of a multidisciplinary approach to imaging-guided axillary staging that facilitates personalized, less invasive surgical management of the axilla through targeted axillary dissection in patients with biopsy-proven nodal metastasis undergoing neoadjuvant chemotherapy.
  
  
  CONCLUSIONS
  Axillary nodal status, critical in breast cancer staging, affects prognosis and treatment. As the paradigm shifts toward minimally invasive therapy, a clip marker is placed in the biopsied metastatic node for patients with N1-N2 disease undergoing neoadjuvant chemotherapy to facilitate targeted axillary dissection of the clipped node. This node is typically localized with a radioactive seed at sentinel lymph node dissection to determine whether further axillary surgery is warranted.
authors.affiliation: 1 Department of Diagnostic Radiology, Breast Imaging, The University of Texas MD Anderson Cancer Center, CPB5.3200, Unit 1350, 1515 Holcombe Blvd, Houston, TX 77030.
authors.forename: Kyungmin
authors.initials: K
authors.lastname: Shin
authors.affiliation: 2 Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Abigail S
authors.initials: AS
authors.lastname: Caudle
authors.affiliation: 2 Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Henry M
authors.initials: HM
authors.lastname: Kuerer
authors.affiliation: 1 Department of Diagnostic Radiology, Breast Imaging, The University of Texas MD Anderson Cancer Center, CPB5.3200, Unit 1350, 1515 Holcombe Blvd, Houston, TX 77030.
authors.forename: Lumarie
authors.initials: L
authors.lastname: Santiago
authors.affiliation: 1 Department of Diagnostic Radiology, Breast Imaging, The University of Texas MD Anderson Cancer Center, CPB5.3200, Unit 1350, 1515 Holcombe Blvd, Houston, TX 77030.
authors.forename: Rosalind P
authors.initials: RP
authors.lastname: Candelaria
authors.affiliation: 1 Department of Diagnostic Radiology, Breast Imaging, The University of Texas MD Anderson Cancer Center, CPB5.3200, Unit 1350, 1515 Holcombe Blvd, Houston, TX 77030.
authors.forename: Basak
authors.initials: B
authors.lastname: Dogan
authors.affiliation: 1 Department of Diagnostic Radiology, Breast Imaging, The University of Texas MD Anderson Cancer Center, CPB5.3200, Unit 1350, 1515 Holcombe Blvd, Houston, TX 77030.
authors.forename: Jessica
authors.initials: J
authors.lastname: Leung
authors.affiliation: 3 Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Savitri
authors.initials: S
authors.lastname: Krishnamurthy
authors.affiliation: 1 Department of Diagnostic Radiology, Breast Imaging, The University of Texas MD Anderson Cancer Center, CPB5.3200, Unit 1350, 1515 Holcombe Blvd, Houston, TX 77030.
authors.forename: Wei
authors.initials: W
authors.lastname: Yang
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology*; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000295:instrumentation / Q000379:methods*; D005260:Female; D057918:Fiducial Markers; D006801:Humans; D007457:Iodine Radioisotopes; D000072662:Margins of Excision; D009367:Neoplasm Staging; D019275:Radiopharmaceuticals; D000071036:Sentinel Lymph Node / Q000473:pathology* / Q000601:surgery*; D021701:Sentinel Lymph Node Biopsy / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals
keywords: axillary lymph node; breast; breast cancer; radioactive seed; targeted axillary dissection; ultrasound