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It consists of the removal of the sentinel lymph nodes (LNs), as well as palpably suspicious nodes. The TAS technique can be utilized in both the upfront and neoadjuvant chemotherapy (NACT) setting. This study assessed whether\/how imaging-guided localization (IGL) influenced TAS.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Patients and Methods<\/jats:title>\n                <jats:p>This was a prospective observational cohort study preplanned in the randomized phase-III OPBC-03\/TAXIS trial. IGL was performed at the surgeon\u2019s discretion for targeted removal of LNs during TAS. Immediate back-up axillary lymph node dissection (ALND) followed TAS according to TAXIS randomization.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Five-hundred patients were included from 44 breast centers in six countries, 151 (30.2%) of whom underwent NACT. IGL was performed in 84.4% of all patients, with significant variation by country (77.6\u2013100%, <jats:italic>p<\/jats:italic> &lt; 0.001). No difference in the median number of removed (5 vs. 4, <jats:italic>p<\/jats:italic> = 0.3) and positive (2 vs. 2, <jats:italic>p<\/jats:italic> = 0.6) LNs by use of IGL was noted. The number of LNs removed during TAS with IGL remained stable over time (<jats:italic>p<\/jats:italic> = 0.8), but decreased significantly without IGL, from six (IQR 4\u20136) in 2019 to four (IQR 3\u20134) in 2022 (<jats:italic>p<\/jats:italic> = 0.015). An ALND was performed in 249 patients, removing another 12 (IQR 9\u201317) LNs, in which a median number of 1 (IQR 0\u20134) was positive. There was no significant difference in residual nodal disease after TAS with or without IGL (68.0% vs. 57.6%, <jats:italic>p<\/jats:italic> = 0.2).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>IGL did not significantly change either the performance of TAS or the volume of residual nodal tumor burden.<\/jats:p>\n                <jats:p><jats:italic>Trial registration<\/jats:italic>: ClinicalTrials.gov Identifier: NCT03513614.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1245\/s10434-023-14404-4","type":"journal-article","created":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T22:03:32Z","timestamp":1698703412000},"page":"344-355","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Impact of Imaging-Guided Localization on Performance of Tailored Axillary Surgery in Patients with Clinically Node-Positive Breast Cancer: Prospective Cohort Study Within TAXIS (OPBC-03, SAKK 23\/16, IBCSG 57-18, ABCSG-53, GBG 101)"],"prefix":"10.1245","volume":"31","author":[{"given":"Walter P.","family":"Weber","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Heidinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Hayoz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoltan","family":"Matrai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Tausch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Henke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel 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Weber received research support from Agendia paid to the University Hospital Basel and honoraria for lectures from MSD. A. Mueller reports personal fees from Lilly, Novartis, Pfizer, Genomic Health, Astra Zeneca, Daiichi Sankyo, Roche, Pierre Fabre, Exact Sciences, Myriad Genetics, Gilead Sciences, Glaxo Smith Kline, MSD, GlaxoSmithKline, and grants from Roche and other from Vifor Stock. Christian Kurzeder reports honoraria from Tesaro, GSK, Astra Zeneca, Novartis, PharmaMar, Genomic Health, Roche, Eli Lilly S.A., Pfizer, Daichi; consulting or advisory role for Tesaro, GSK, Astra Zeneca, Novartis, PharmaMar, Genomic Health, Roche, Eli Lilly S.A., Merck MSD, Pfizer, and travel, accommodations and expenses from GSK, Astra Zeneca, and Roche. M. Gnant reports personal fees\/travel support from AstraZeneca, DaiichiSankyo, EliLilly, Menarini-Stemline, MSD, Novartis, PierreFabre, Veracyte; an immediate family member is employed by Sandoz. S. Loibl reports grants from AZ, Abbvie DSI, Molecular Health, BMS\/Celgene, Gilead, Novartis, Pfizer and Roche, honorarium for ad.board and presentations from AZ, Amgen, Gilead, BMS, Novartis, Pfizer, Seagen, Sanofi, Relay, Olema, Incyte, Roche, Merck KG, Lilly and GSK, non-financial medical writing support from AZ, Pfizer, Roche, Novartis, DSI, Cellcuity outside the submitted work. In addition, S. Loibl reports a patent for VM Scope with royalties paid to institute, a patent for EP14153692.0 pending, a patent for EP21152186.9 pending, and a patent for EP15702464.7 pending. F. Fitzal reports personal fees from Novartis, Astra Zeneca, Roche and MSD. D. Egle reports personal fees from AstraZeneca, Daiichi Sankyo, Gilead, MSD, Novartis, Pfizer, Sirius, and non-financial support from Roche outside the submitted work. M. Knauer reports grants from Agendia and grants from Swiss Cancer Research during the conduct of the study; other from Myriad Advisory Board outside the submitted work. All other authors report no conflicts of interest.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}}]}}