{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T20:13:44Z","timestamp":1764101624624,"version":"3.37.3"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2021,6,17]],"date-time":"2021-06-17T00:00:00Z","timestamp":1623888000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,17]],"date-time":"2021-06-17T00:00:00Z","timestamp":1623888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002345","name":"Eberhard Karls Universit\u00e4t T\u00fcbingen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002345","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Gynecol Obstet"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Clip-marking of axillary lymph nodes with initial biopsy-confirmed metastasis is required for targeted axillary dissection (TAD), which includes sentinel lymph node dissection (SLND) and selective localization and removal of the clipped targeted lymph node. There have been several studies which examined the feasibility of TAD in routine clinical use. In this context, the optimal clip visualisation was noted as one of the crucial limiting factors. We, therefore, evaluated the sonographic detectability of 10 different commercially available markers within an in vitro model simulating the anatomical composition of the axilla.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>In this standardised model consisting of porcine fat with 30\u00a0mm thickness, the visibility of a total of ten markers was analysed in all 3 planes (parallel, diagonal, orthograde) with wire guidance and then classified into either \u201cvisibility good\u201d, \u201cvisibility moderate\u201d or \u201cvisibility poor\u201d with regard to the alignment of the transducer. Additionally, \u201creal-life conditions\u201d were simulated, in which the markers were searched without any wires guidance.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>It was observed that, while not all markers are detectable in fatty tissue, markers with spherical shape (non-embedded Inconel or Nitinol) or rectangular-shaped Titanium markers with embedded material have a clear advantage. 3D-shaped markers can always be detected in all three axes, which is of particular importance in the axilla with its pyramid shape and fatty tissue.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The shape and the embedding of the material play a crucial role for visibility and efficacy of the marker, as reliable marking of suspicious and pathological axillary lymph nodes is essential for TAD.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00404-021-06085-9","type":"journal-article","created":{"date-parts":[[2021,6,17]],"date-time":"2021-06-17T18:02:51Z","timestamp":1623952971000},"page":"839-848","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Evaluation of sonographic detectability of different markers within an in vitro simulation model of the axilla"],"prefix":"10.1007","volume":"304","author":[{"given":"Selin","family":"Guergan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uta","family":"Hoopmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Roehm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bettina","family":"Boeer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Regina","family":"Fugunt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gisela","family":"Helms","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Seller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Marx","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ernst","family":"Oberlechner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Hartkopf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heike","family":"Preibsch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Brucker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diethelm","family":"Wallwiener","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Hahn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3170-505X","authenticated-orcid":false,"given":"Ines Verena","family":"Gruber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,6,17]]},"reference":[{"issue":"5","key":"6085_CR1","first-page":"557","volume":"28","author":"WS Halsted","year":"1898","unstructured":"Halsted WS (1898) A clinical and histological study of certain adenocarcinomata of the breast: and a brief consideration of the supraclavicular operation and of the results of operations for cancer of the breast from 1889 to 1898 at the Johns Hopkins Hospital. Ann Surg 28(5):557\u2013576","journal-title":"Ann Surg"},{"issue":"9","key":"6085_CR2","doi-asserted-by":"publisher","first-page":"1307","DOI":"10.1016\/j.ejso.2018.05.035","volume":"44","author":"S Hartmann","year":"2018","unstructured":"Hartmann S, Reimer T, Gerber B, Stubert J, Stangel B, Stachs A (2018) Wire localization of clip-markes axiallry lmyphnodes in breast cancer patients treated with primary systemic therapy. Eur J Surg Oncol 44(9):1307\u20131311. https:\/\/doi.org\/10.1016\/j.ejso.2018.05.035","journal-title":"Eur J Surg Oncol"},{"issue":"14","key":"6085_CR3","doi-asserted-by":"publisher","first-page":"1455","DOI":"10.1001\/jama.2013.278932","volume":"310","author":"JC Boughey","year":"2013","unstructured":"Boughey JC, Suman VJ, Mittendorf EA et al (2013) Alliance for clinical trials in oncology: sentinel lymph node surgery after neoadjuvant chemotherapy in patients with node-positive breast cancer: The ACOSOG Z1071 (Alliance) clinical trial. JAMA 310(14):1455\u20131461. https:\/\/doi.org\/10.1001\/jama.2013.278932","journal-title":"JAMA"},{"issue":"5","key":"6085_CR4","doi-asserted-by":"publisher","first-page":"1549","DOI":"10.1245\/s10434-015-5052-8.b","volume":"23","author":"EJ Diego","year":"2016","unstructured":"Diego EJ, McAuliffe PF, Soran A, McGuire KP, Johnson RR, Bonaventura M et al (2016) Axillary staging after neoadjuvant chemotherapy for breast cancer: a pilot study combining sentinel lymph node biopsy with radiactive seed localization of pretreatment positive axillary lymph nodes. Ann Surg Oncol 23(5):1549\u20131553. https:\/\/doi.org\/10.1245\/s10434-015-5052-8.b","journal-title":"Ann Surg Oncol"},{"issue":"7","key":"6085_CR5","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1016\/S1470-2045(13)70166-9","volume":"14","author":"T Kuehn","year":"2013","unstructured":"Kuehn T, Bauerfeind I, Fehm T, Fleige B, Hausschild M, Helms G, Lebeau A, Liedtke C, von Minckwitz G, Nekljudova V, Schmatloch S, Schrenk P, Staebler A, Untch M (2013) Sentinel-lymph-node biopsy in patients with breast cancer before and after neoadjuvant chemotherapy (SENTINA): a prospective, multicentre cohort study. Lancet Oncol 14(7):609\u2013618. https:\/\/doi.org\/10.1016\/S1470-2045(13)70166-9","journal-title":"Lancet Oncol"},{"issue":"10","key":"6085_CR6","doi-asserted-by":"publisher","first-page":"1072","DOI":"10.1200\/JCO.2015.64.0094","volume":"34","author":"AS Caudle","year":"2016","unstructured":"Caudle AS, Yang WT, Krishnamurthy S, Mittendorf EA, Black DM, Gilcrease MZ, Bedrosian I, Hobbs BP, DeSnyder SM, Hwang RF, Adrada BE, Shaitelman SF, Chavez-MacGregor M, Smith BD, Candelaria RP, Babiera GV, Dogan BE, Santiago L, Hunt KK, Kuerer HM (2016) Improved axillary evaluation following neoadjuvant therapy for patients with node-positive breast cancer using selective evaluation of clipped nodes: implementation of targeted axillary dissection. J Clin Oncol 34(10):1072\u20131078. https:\/\/doi.org\/10.1200\/JCO.2015.64.0094","journal-title":"J Clin Oncol"},{"issue":"8","key":"6085_CR7","doi-asserted-by":"publisher","first-page":"1226","DOI":"10.1002\/bjs.7073","volume":"97","author":"ME Straver","year":"2010","unstructured":"Straver ME, Loo CE, Alderliesten T, Rutgers EJ, Vrancken Peeters MT (2010) Marking the axilla with radioactive iodine seeds (MARI procedure) may reduce the need for axillary dissection after neoadjuvant chemotherapy for breast cancer. Br J Surg 97(8):1226\u20131231. https:\/\/doi.org\/10.1002\/bjs.7073","journal-title":"Br J Surg"},{"doi-asserted-by":"publisher","unstructured":"Natsiopoulos I, Intzes S, Liappis T, Zarampoukas K, Zarampoukas T, Zacharopoulou V, Papazisis K. Axillary lymph node tattooing and targeted axillary dissection in breast cancer patients who presented as cN+ before neoadjuvant chemotherapy and became cN0 after treatment. Clin Breast Cancer. 2019;19(3):208-215. https:\/\/doi.org\/10.1016\/j.clbc.2019.01.013","key":"6085_CR8","DOI":"10.1016\/j.clbc.2019.01.013"},{"unstructured":"Die Arbeitsgemeinschaft Gyn\u00e4kologische Onkologie (2020) Breast cancer surgery - oncological aspects. https:\/\/www.ago-online.de\/fileadmin\/ago-online\/downloads\/_leitlinien\/kommission_mamma\/2020\/PDF_EN\/2020E%2008_Breast%20Cancer%20Surgery%20-%20Oncological%20Aspects.pdf, last visited 23.03.2021","key":"6085_CR9"},{"doi-asserted-by":"publisher","unstructured":"Kuemmel S, Heil J, Rueland A, Seiberling C et al (2020) A prospective, multicenter registry study to evaluate the clinical feasibility of targeted axillary dissection (TAD) in node-positive breast cancer patients. Ann Surg https:\/\/doi.org\/10.1097\/SLA.0000000000004572","key":"6085_CR10","DOI":"10.1097\/SLA.0000000000004572"},{"issue":"10","key":"6085_CR11","doi-asserted-by":"publisher","first-page":"3011","DOI":"10.1245\/s10434-017-6023-z","volume":"24","author":"TT Nguyen","year":"2017","unstructured":"Nguyen TT, Hieken TJ, Glazebrook KN, Boughey JC (2017) Localizing the clipped node in patients with node-positive breast cancer treated with neoadjuvant chemotherapy: early learning experience and challenges. Ann Surg Oncol 24(10):3011\u20133016. https:\/\/doi.org\/10.1245\/s10434-017-6023-z","journal-title":"Ann Surg Oncol"},{"issue":"2","key":"6085_CR12","doi-asserted-by":"publisher","first-page":"401","DOI":"10.7863\/ultra.16.02053","volume":"36","author":"M Carmon","year":"2017","unstructured":"Carmon M, Olsha O, Gekhtman D, Nikitin I, Cohen Y, Messing M, Lioubashevsky N, Abu Dalo R, Hadar T, Golomb E (2017) Detectability of hygroscopic clips used in breast cancer surgery. J Ultrasound Med 36(2):401\u2013408. https:\/\/doi.org\/10.7863\/ultra.16.02053","journal-title":"J Ultrasound Med"},{"issue":"2","key":"6085_CR13","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1159\/000486388","volume":"13","author":"AM R\u00fcland","year":"2018","unstructured":"R\u00fcland AM, Hagemann F, Reinisch M, Holtschmidt J, K\u00fcmmel A, Dittmer-Grabowski C, St\u00f6blen F, Rotthaus H, Dreesmann V, Blohmer JU, K\u00fcmmel S (2018) Using a new marker clip system in breast cancer: tumark vision\u00ae clip - feasibility testing in everyday clinical practice. Breast Care (Basel) 13(2):116\u2013120. https:\/\/doi.org\/10.1159\/000486388","journal-title":"Breast Care (Basel)"},{"issue":"1065","key":"6085_CR14","doi-asserted-by":"publisher","first-page":"20160149","DOI":"10.1259\/bjr.20160149","volume":"89","author":"DM Pinkney","year":"2016","unstructured":"Pinkney DM, Mychajlowycz M, Shah BA (2016) A prospective comparative study to evaluate the displacement of four commercially available breast biopsy markers. Br J Radiol 89(1065):20160149. https:\/\/doi.org\/10.1259\/bjr.20160149","journal-title":"Br J Radiol"},{"issue":"2","key":"6085_CR15","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1007\/s00404-019-05428-x","volume":"301","author":"M Banys-Paluchowski","year":"2020","unstructured":"Banys-Paluchowski M, Gruber IV, Hartkopf A, Paluchowski P, Krawczyk N, Marx M, Brucker S, Hahn M (2020) Axillary ultrasound for prediction of response to neoadjuvant therapy in the context of surgical strategies to axillary dissection in primary breast cancer: a systematic review of the current literature. Arch Gynecol Obstet 301(2):341\u2013353. https:\/\/doi.org\/10.1007\/s00404-019-05428-x","journal-title":"Arch Gynecol Obstet"},{"issue":"13","key":"6085_CR16","doi-asserted-by":"publisher","first-page":"4241","DOI":"10.1245\/s10434-015-4527-y","volume":"22","author":"D Plecha","year":"2015","unstructured":"Plecha D, Bai S, Patterson H, Thompson C, Shenk R (2015) Improving the accuracy of axillary lymph node surgery in breast cancer with ultrasound-guided wire localization of biopsy proven metastatic lymph nodes. Ann Surg Oncol 22(13):4241\u20134246. https:\/\/doi.org\/10.1245\/s10434-015-4527-y","journal-title":"Ann Surg Oncol"},{"issue":"1","key":"6085_CR17","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1007\/BF02967485","volume":"8","author":"K Tamai","year":"2001","unstructured":"Tamai K, Mitsumori M, Fujishiro S, Kokubo M, Ooya N, Nagata Y, Sasai K, Hiraoka M, Inamoto T (2001) A case of allergic reaction to surgical metal clips inserted for postoperative boost irradiation in a patient undergoing Breast-conserving therapy. Breast Cancer 8(1):90\u201392. https:\/\/doi.org\/10.1007\/BF02967485","journal-title":"Breast Cancer"},{"doi-asserted-by":"publisher","unstructured":"Banys-Paluchowski M, Stickeler E, de Boniface J (2020) AXSANA (AXillary Surgery After NeoAdjuvant Treatment): A European prospective multicenter cohort study to evaluate different surgical methods of axillary staging (sentinel lymph node biopsy, targeted axillary dissection, axillary dissection) in clinically node-positive breast cancer patients treated with neoadjuvant chemotherapy. Senologie 17(02): 2 https:\/\/doi.org\/10.1055\/s-0040-1710600","key":"6085_CR18","DOI":"10.1055\/s-0040-1710600"}],"container-title":["Archives of Gynecology and Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00404-021-06085-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00404-021-06085-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00404-021-06085-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,31]],"date-time":"2021-07-31T09:08:16Z","timestamp":1627722496000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00404-021-06085-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,17]]},"references-count":18,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["6085"],"URL":"https:\/\/doi.org\/10.1007\/s00404-021-06085-9","relation":{},"ISSN":["0932-0067","1432-0711"],"issn-type":[{"type":"print","value":"0932-0067"},{"type":"electronic","value":"1432-0711"}],"subject":[],"published":{"date-parts":[[2021,6,17]]},"assertion":[{"value":"25 January 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 April 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 June 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"There is no conflict of interest or competing interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}]}}