Current Indications for the Seed Marked Axillary Lymph Node Dissection in Breast Cancer

Marker placement in a pathological node improves extirpation rates in breast cancer cases with limited axillary involvement. Our goal was to assess current indications for seed marked axillary lymph node dissection (SMALND). We conducted a descriptive observational study including 93 patients with cN1 breast cancer between January 2019 and December 2023. Seed placement was performed under ultrasound guidance days before the procedure. Intraoperative detection was achieved using a probe, and resection was confirmed radiologically. The primary indication was post neoadjuvant therapy (72 patients: 60 chemotherapy and 12 hormone therapy), followed by initial surgery (13), and single axillary recurrence (8). The extirpation rate of the marked axillary lymph node was 100%. In Target Axillary Dissection (TAD), the concordance rate between sentinel node and marked axillary node was 85%. In the 12 cases of initial surgery, axillary lymphadenectomy was avoided because the marked node matched the sentinel node and was the only one involved. The use of seeds has proven to be highly useful in axillary surgery, both in cases of negativization following neoadjuvant therapy and in those with low axillary involvement or single axillary recurrence.