{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T19:15:02Z","timestamp":1784229302447,"version":"3.55.0"},"reference-count":99,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T00:00:00Z","timestamp":1680480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fondazione Policlinico Agostino Gemelli\u2013IRCCS"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Targeted axillary dissection (TAD) is an axillary staging technique after NACT that involves the removal of biopsy-proven metastatic lymph nodes in addition to sentinel lymph node biopsy (SLNB). This technique avoids the morbidity of traditional axillary lymph node dissection and has shown a lower false-negative rate than SLNB alone. Therefore, marking positive axillary lymph nodes before NACT is critical in order to locate and remove them in the subsequent surgery. Current localization methods include clip placement with intraoperative ultrasound, carbon-suspension liquids, localization wires, radioactive tracer-based localizers, magnetic seeds, radar reflectors, and radiofrequency identification devices. The aim of this paper is to illustrate the management of axillary lymph nodes based on current guidelines and explain the features of axillary lymph node markers, with relative advantages and disadvantages.<\/jats:p>","DOI":"10.3390\/cancers15072130","type":"journal-article","created":{"date-parts":[[2023,4,4]],"date-time":"2023-04-04T01:35:59Z","timestamp":1680572159000},"page":"2130","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Image-Guided Localization Techniques for Metastatic Axillary Lymph Nodes in Breast Cancer; What Radiologists Should Know"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1234-003X","authenticated-orcid":false,"given":"Valerio","family":"Di Paola","sequence":"first","affiliation":[{"name":"Department of Bioimaging, Radiation Oncology and Hematology, UOC of Radiodiagnostica Presidio Columbus, Fondazione Policlinico Universitario A. 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Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8824-2535","authenticated-orcid":false,"given":"Simone","family":"Palma","sequence":"additional","affiliation":[{"name":"Department of Bioimaging, Radiation Oncology and Hematology, UOC of Radiodiagnostica Presidio Columbus, Fondazione Policlinico Universitario A. Gemelli IRCSS, Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Orsini","sequence":"additional","affiliation":[{"name":"Institute of Radiology, Catholic University of the Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Mola","sequence":"additional","affiliation":[{"name":"Institute of Radiology, Catholic University of the Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Ferrara","sequence":"additional","affiliation":[{"name":"Institute of Radiology, Catholic University of the Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Longo","sequence":"additional","affiliation":[{"name":"Institute of Radiology, Catholic University of the Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enida","family":"Bufi","sequence":"additional","affiliation":[{"name":"Department of Bioimaging, Radiation Oncology and Hematology, UOC of Radiologia Toracica e Cardiovascolare, Fondazione Policlinico Universitario A. Gemelli IRCSS, Largo A. 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Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Clauser","sequence":"additional","affiliation":[{"name":"Department of Biomedical Imaging and Image-Guided Radiotherapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7979-2466","authenticated-orcid":false,"given":"Paolo","family":"Belli","sequence":"additional","affiliation":[{"name":"Institute of Radiology, Catholic University of the Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy"},{"name":"Department of Bioimaging, Radiation Oncology and Hematology, UOC of Radiologia Toracica e Cardiovascolare, Fondazione Policlinico Universitario A. Gemelli IRCSS, Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4972-9500","authenticated-orcid":false,"given":"Riccardo","family":"Manfredi","sequence":"additional","affiliation":[{"name":"Department of Bioimaging, Radiation Oncology and Hematology, UOC of Radiodiagnostica Presidio Columbus, Fondazione Policlinico Universitario A. Gemelli IRCSS, Largo A. Gemelli 8, 00168 Rome, Italy"},{"name":"Institute of Radiology, Catholic University of the Sacred Heart, Largo A. Gemelli 8, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Panico, C., Ferrara, F., Woitek, R., D\u2019Angelo, A., Di Paola, V., Bufi, E., Conti, M., Palma, S., Cicero, S.L., and Cimino, G. (2022). Staging Breast Cancer with MRI, the T. A Key Role in the Neoadjuvant Setting. Cancers, 14.","DOI":"10.3390\/cancers14235786"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/j.breast.2005.06.010","article-title":"Node-Related Factors and Survival in Node-Positive Breast Carcinomas","volume":"15","author":"Sivridis","year":"2006","journal-title":"Breast"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1186\/s12957-021-02209-2","article-title":"New Classifications of Axillary Lymph Nodes and Their Anatomical-Clinical Correlations in Breast Surgery","volume":"19","author":"Cirocchi","year":"2021","journal-title":"World J. Surg. 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Sentinel Lymph Node Surgery after Neoadjuvant Chemotherapy in Patients with Node-Positive Breast Cancer: The ACOSOG Z1071 (Alliance) Clinical Trial","volume":"310","author":"Boughey","year":"2013","journal-title":"JAMA"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1007\/s00432-020-03461-x","article-title":"Sentinel Lymph Node Detection by Means of Indocyanine Green Using the Karl Storz VITOM\u00ae Fluorescence Camera: A Comparison between Primary Sentinel Lymph Node Biopsy versus Sentinel Lymph Node Biopsy after Neoadjuvant Chemotherapy","volume":"147","author":"Staubach","year":"2021","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Pelc, Z., Sk\u00f3rzewska, M., Kurylcio, M., Nowikiewicz, T., Mlak, R., S\u0119d\u0142ak, K., G\u0119ca, K., Rawicz-Pruszy\u0144ski, K., Zegarski, W., and Polkowski, W.P. (2022). A Propensity Score Matched Analysis of Superparamagnetic Iron Oxide versus Radioisotope Sentinel Node Biopsy in Breast Cancer Patients after Neoadjuvant Chemotherapy. Cancers, 14.","DOI":"10.3390\/cancers14030676"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1093\/annonc\/mdz173","article-title":"Early Breast Cancer: ESMO Clinical Practice Guidelines for Diagnosis, Treatment and Follow-Up","volume":"30","author":"Cardoso","year":"2019","journal-title":"Ann. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"691","DOI":"10.6004\/jnccn.2022.0030","article-title":"Breast Cancer, Version 3.2022, NCCN Clinical Practice Guidelines in Oncology","volume":"20","author":"Gradishar","year":"2022","journal-title":"J. Natl. Compr. Cancer Netw. JNCCN"},{"key":"ref_14","first-page":"804","article-title":"Long-Term Standard Sentinel Node Biopsy after Neoadjuvant Treatment in Breast Cancer: A Single Institution Ten-Year Follow-Up","volume":"47","author":"Pagan","year":"2021","journal-title":"Eur. J. Surg. Oncol. J. Eur. Soc. Surg. Oncol. Br. Assoc. Surg. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1007\/s10549-018-5004-7","article-title":"Sentinel Lymph Node Biopsy without Axillary Lymphadenectomy after Neoadjuvant Chemotherapy Is Accurate and Safe for Selected Patients: The GANEA 2 Study","volume":"173","author":"Classe","year":"2019","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2884","DOI":"10.1002\/cncr.25152","article-title":"Cytologically Proven Axillary Lymph Node Metastases Are Eradicated in Patients Receiving Preoperative Chemotherapy with Concurrent Trastuzumab for HER2-Positive Breast Cancer","volume":"116","author":"Dominici","year":"2010","journal-title":"Cancer"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3676","DOI":"10.1200\/JCO.2005.07.032","article-title":"Significantly Higher Pathologic Complete Remission Rate after Neoadjuvant Therapy with Trastuzumab, Paclitaxel, and Epirubicin Chemotherapy: Results of a Randomized Trial in Human Epidermal Growth Factor Receptor 2-Positive Operable Breast Cancer","volume":"23","author":"Buzdar","year":"2005","journal-title":"J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"3177","DOI":"10.1245\/s10434-012-2484-2","article-title":"The Role for Sentinel Lymph Node Dissection after Neoadjuvant Chemotherapy in Patients Who Present with Node-Positive Breast Cancer","volume":"19","author":"Alvarado","year":"2012","journal-title":"Ann. Surg. Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1016\/S1470-2045(13)70166-9","article-title":"Sentinel-Lymph-Node Biopsy in Patients with Breast Cancer before and after Neoadjuvant Chemotherapy (SENTINA): A Prospective, Multicentre Cohort Study","volume":"14","author":"Kuehn","year":"2013","journal-title":"Lancet Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1200\/JCO.2014.55.7827","article-title":"Sentinel Node Biopsy after Neoadjuvant Chemotherapy in Biopsy-Proven Node-Positive Breast Cancer: The SN FNAC Study","volume":"33","author":"Boileau","year":"2015","journal-title":"J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1097\/00000478-200009000-00010","article-title":"Identification and Evaluation of Axillary Sentinel Lymph Nodes in Patients with Breast Carcinoma Treated with Neoadjuvant Chemotherapy","volume":"24","author":"Cohen","year":"2000","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1007\/s10549-006-9192-1","article-title":"Factors Affecting Failed Localisation and False-Negative Rates of Sentinel Node Biopsy in Breast Cancer\u2014Results of the ALMANAC Validation Phase","volume":"99","author":"Goyal","year":"2006","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1038\/nrclinonc.2015.63","article-title":"Surgical Issues in Patients with Breast Cancer Receiving Neoadjuvant Chemotherapy","volume":"12","author":"King","year":"2015","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1097\/SLA.0000000000001375","article-title":"Identification and Resection of Clipped Node Decreases the False-Negative Rate of Sentinel Lymph Node Surgery in Patients Presenting With Node-Positive Breast Cancer (T0-T4, N1-N2) Who Receive Neoadjuvant Chemotherapy: Results From ACOSOG Z1071 (Alliance)","volume":"263","author":"Boughey","year":"2016","journal-title":"Ann. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1200\/JCO.2015.64.0094","article-title":"Improved Axillary Evaluation Following Neoadjuvant Therapy for Patients With Node-Positive Breast Cancer Using Selective Evaluation of Clipped Nodes: Implementation of Targeted Axillary Dissection","volume":"34","author":"Caudle","year":"2016","journal-title":"J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1001\/jamasurg.2014.1086","article-title":"Selective Surgical Localization of Axillary Lymph Nodes Containing Metastases in Patients with Breast Cancer: A Prospective Feasibility Trial","volume":"150","author":"Caudle","year":"2015","journal-title":"JAMA Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e12580","DOI":"10.1200\/JCO.2022.40.16_suppl.e12580","article-title":"Axillary Surgery after Neoadjuvant Chemotherapy in Breast Cancer Patients Downstaging from CN+ to YcN0","volume":"40","author":"Krivorotko","year":"2022","journal-title":"J. Clin. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e553","DOI":"10.1097\/SLA.0000000000004572","article-title":"A Prospective, Multicenter Registry Study to Evaluate the Clinical Feasibility of Targeted Axillary Dissection (TAD) in Node-Positive Breast Cancer Patients","volume":"276","author":"Kuemmel","year":"2022","journal-title":"Ann. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.suronc.2020.11.013","article-title":"Advantages of Preoperative Localization and Surgical Resection of Metastatic Axillary Lymph Nodes Using Magnetic Seeds after Neoadjuvant Chemotherapy in Breast Cancer","volume":"36","author":"Catanese","year":"2021","journal-title":"Surg. Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1001\/jamasurg.2022.3907","article-title":"Diagnostic Accuracy of Radioactive Iodine Seed Placement in the Axilla With Sentinel Lymph Node Biopsy After Neoadjuvant Chemotherapy in Node-Positive Breast Cancer","volume":"157","author":"Simons","year":"2022","journal-title":"JAMA Surg."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Swarnkar, P.K., Tayeh, S., Michell, M.J., and Mokbel, K. (2021). The Evolving Role of Marked Lymph Node Biopsy (MLNB) and Targeted Axillary Dissection (TAD) after Neoadjuvant Chemotherapy (NACT) for Node-Positive Breast Cancer: Systematic Review and Pooled Analysis. Cancers, 13.","DOI":"10.21203\/rs.3.rs-199729\/v1"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1245\/s10434-017-6270-z","article-title":"Intraoperative Ultrasound-Guided Excision of Axillary Clip in Patients with Node-Positive Breast Cancer Treated with Neoadjuvant Therapy (ILINA Trial): A New Tool to Guide the Excision of the Clipped Node After Neoadjuvant Treatment","volume":"25","author":"Siso","year":"2018","journal-title":"Ann. Surg. Oncol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"101823","DOI":"10.1016\/j.suronc.2022.101823","article-title":"Feasibility of Targeted Axillary Dissection for De-Escalation of Surgical Treatment after Neoadjuvant Chemotherapy in Breast Cancer","volume":"44","author":"Galindo","year":"2022","journal-title":"Surg. Oncol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1016\/j.annonc.2021.06.023","article-title":"Customizing Local and Systemic Therapies for Women with Early Breast Cancer: The St. Gallen International Consensus Guidelines for Treatment of Early Breast Cancer 2021","volume":"32","author":"Burstein","year":"2021","journal-title":"Ann. Oncol. Off. J. Eur. Soc. Med. Oncol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"3056","DOI":"10.1200\/JCO.21.00934","article-title":"Management of the Axilla in Early-Stage Breast Cancer: Ontario Health (Cancer Care Ontario) and ASCO Guideline","volume":"39","author":"Brackstone","year":"2021","journal-title":"J. Clin. Oncol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1159\/000524879","article-title":"AGO Recommendations for the Diagnosis and Treatment of Patients with Early Breast Cancer: Update 2022","volume":"17","author":"Ditsch","year":"2022","journal-title":"Breast Care"},{"key":"ref_37","unstructured":"(2022). Consensus Statement on Axillary Management for Patients with In-Situ and Invasive Breast Cancer: A Concise Overview, The American Society of Breast Surgeons."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1007\/s10549-011-1847-x","article-title":"A Plea for the Biopsy Marker: How, Why and Why Not Clipping after Breast Biopsy?","volume":"132","author":"Lalonde","year":"2012","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.2214\/ajr.175.4.1751053","article-title":"Clip Placement during Sonographically Guided Large-Core Breast Biopsy for Mammographic-Sonographic Correlation","volume":"175","author":"Guenin","year":"2000","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1148\/radiology.205.2.9356622","article-title":"Clip Placement after Stereotactic Vacuum-Assisted Breast Biopsy","volume":"205","author":"Liberman","year":"1997","journal-title":"Radiology"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1007\/s00117-005-1173-6","article-title":"Clip marker placement following MR-guided vacuum biopsy of the breast","volume":"45","author":"Perlet","year":"2005","journal-title":"Radiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1016\/j.amjsurg.2014.07.010","article-title":"Localization of Nonpalpable Breast Lesions with Sonographically Visible Clip: Optimizing Tailored Resection and Clear Margins","volume":"209","author":"Corsi","year":"2015","journal-title":"Am. J. Surg."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Murthy, V., Young, J., Tokumaru, Y., Quinn, M., Edge, S.B., and Takabe, K. (2021). Options to Determine Pathological Response of Axillary Lymph Node Metastasis after Neoadjuvant Chemotherapy in Advanced Breast Cancer. Cancers, 13.","DOI":"10.3390\/cancers13164167"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1016\/S0002-9610(03)00277-0","article-title":"Single-Step Ultrasound Localization of Breast Lesions and Lumpectomy Procedure","volume":"186","author":"Gittleman","year":"2003","journal-title":"Am. J. Surg."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/j.acra.2009.10.017","article-title":"Preoperative and Intraoperative Sonographic Visibility of Collagen-Based Breast Biopsy Marker Clips","volume":"17","author":"Eby","year":"2010","journal-title":"Acad. Radiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1002\/jso.22146","article-title":"Evaluation of a Hydrogel Based Breast Biopsy Marker (HydroMARK\u00ae) as an Alternative to Wire and Radioactive Seed Localization for Non-Palpable Breast Lesions","volume":"105","author":"Klein","year":"2012","journal-title":"J. Surg. Oncol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10549-014-2926-6","article-title":"Why Should Breast Surgeons Use Ultrasound?","volume":"145","author":"Ahmed","year":"2014","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_48","first-page":"401","article-title":"Detectability of Hygroscopic Clips Used in Breast Cancer Surgery","volume":"36","author":"Carmon","year":"2017","journal-title":"J. Ultrasound Med. Off. J. Am. Inst. Ultrasound Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"3273","DOI":"10.1245\/s10434-014-3917-x","article-title":"Use of Hydrogel Breast Biopsy Tissue Markers Reduces the Need for Wire Localization","volume":"21","author":"Blumencranz","year":"2014","journal-title":"Ann. Surg. Oncol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1055\/a-1471-4234","article-title":"Targeted Removal of Axillary Lymph Nodes After Carbon Marking in Patients with Breast Cancer Treated with Primary Chemotherapy","volume":"81","author":"Hartmann","year":"2021","journal-title":"Geburtshilfe Frauenheilkd."},{"key":"ref_51","first-page":"1112","article-title":"Abnormal Mammography and Sonography Associated with Foreign-Body Giant-Cell Reaction after Stereotactic Vacuum-Assisted Breast Biopsy with Carbon Marking","volume":"49","year":"2008","journal-title":"Acta Radiol. Stockh. Swed. 1987"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1093\/bjs\/znaa083","article-title":"Carbon Tattooing for Targeted Lymph Node Biopsy after Primary Systemic Therapy in Breast Cancer: Prospective Multicentre TATTOO Trial","volume":"108","author":"Hartmann","year":"2021","journal-title":"Br. J. Surg."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1111\/tbj.13736","article-title":"Targeted Axillary Dissection of Carbon-Tattooed Metastatic Lymph Nodes in Combination with Post-Neo-Adjuvant Sentinel Lymph Node Biopsy Using 1% Methylene Blue in Breast Cancer Patients","volume":"26","author":"Khallaf","year":"2020","journal-title":"Breast J."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1245\/s10434-014-4034-6","article-title":"Initial Results with Preoperative Tattooing of Biopsied Axillary Lymph Nodes and Correlation to Sentinel Lymph Nodes in Breast Cancer Patients","volume":"22","author":"Choy","year":"2015","journal-title":"Ann. Surg. Oncol."},{"key":"ref_55","first-page":"61","article-title":"Target Lymph Node Biopsy (TLNB) nach Kohlenstoffmarkierung bei Mammakarzinom-Patientinnen im Rahmen der prim\u00e4ren Systemtherapie\u2014Ergebnisse der TATTOO-Studie","volume":"Volume 80","author":"Hartmann","year":"2020","journal-title":"Geburtshilfe und Frauenheilkunde"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.clbc.2019.01.013","article-title":"Axillary Lymph Node Tattooing and Targeted Axillary Dissection in Breast Cancer Patients Who Presented as CN+ Before Neoadjuvant Chemotherapy and Became CN0 After Treatment","volume":"19","author":"Natsiopoulos","year":"2019","journal-title":"Clin. Breast Cancer"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1111\/tbj.12597","article-title":"CT-Guided Wire Localization for Involved Axillary Lymph Nodes After Neo-Adjuvant Chemotherapy in Patients With Initially Node-Positive Breast Cancer","volume":"22","author":"Trinh","year":"2016","journal-title":"Breast J."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1016\/j.acra.2018.07.002","article-title":"A Review of Options for Localization of Axillary Lymph Nodes in the Treatment of Invasive Breast Cancer","volume":"26","author":"Woods","year":"2019","journal-title":"Acad. Radiol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/j.rcl.2016.12.012","article-title":"Update on Preoperative Breast Localization","volume":"55","author":"Hayes","year":"2017","journal-title":"Radiol. Clin. North Am."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.breast.2013.04.016","article-title":"Radioactive Seed Localisation (RSL) in the Treatment of Non-Palpable Breast Cancers: Systematic Review and Meta-Analysis","volume":"22","author":"Ahmed","year":"2013","journal-title":"Breast"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/S0748-7983(98)92527-6","article-title":"Migration of the Guide-Wire into the Pleural Cavity after Needle Localization of Breast Lesions","volume":"24","author":"Barendregt","year":"1998","journal-title":"Eur. J. Surg. Oncol. EJSO"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"787","DOI":"10.2214\/ajr.150.4.787","article-title":"Migration of Breast Biopsy Localization Wire","volume":"150","author":"Davis","year":"1988","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1002\/jso.10218","article-title":"Cardiac Injury during Needle Localized Surgical Breast Biopsy","volume":"82","author":"Martinez","year":"2003","journal-title":"J. Surg. Oncol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1259\/0007-1285-54-638-139","article-title":"Transgression of Localizing Wire into the Pleural Cavity Prior to Mammography","volume":"54","author":"Bristol","year":"1981","journal-title":"Br. J. Radiol."},{"key":"ref_65","first-page":"5","article-title":"Transection of the Localization Hooked Wire during Breast Biopsy","volume":"141","author":"Mj","year":"1983","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1007\/s10549-018-4709-y","article-title":"Safety and Feasibility of Breast Lesion Localization Using Magnetic Seeds (Magseed): A Multi-Centre, Open-Label Cohort Study","volume":"169","author":"Harvey","year":"2018","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"913","DOI":"10.2214\/AJR.17.18345","article-title":"Initial Clinical Experience With an Inducible Magnetic Seed System for Preoperative Breast Lesion Localization","volume":"210","author":"Price","year":"2018","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_68","unstructured":"(2023, February 24). Mammotome: Massima Efficienza, Cure Ottimizzate. Available online: https:\/\/it.mammotome.com."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.breast.2017.03.003","article-title":"Feasibility of Magnetic Marker Localisation for Non-Palpable Breast Cancer","volume":"33","author":"Schermers","year":"2017","journal-title":"Breast"},{"key":"ref_70","unstructured":"(2023, February 24). Merit Oncology. Merit Medical. Available online: https:\/\/www.merit.com\/merit-oncology\/."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1324","DOI":"10.5858\/arpa.2017-0214-RA","article-title":"Localization for Breast Surgery: The Next Generation","volume":"141","author":"Jeffries","year":"2017","journal-title":"Arch. Pathol. Lab. Med."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"3168","DOI":"10.1245\/s10434-016-5405-y","article-title":"A Prospective, Single Arm, Multi-Site, Clinical Evaluation of a Nonradioactive Surgical Guidance Technology for the Location of Nonpalpable Breast Lesions during Excision","volume":"23","author":"Cox","year":"2016","journal-title":"Ann. Surg. Oncol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"W69","DOI":"10.2214\/AJR.15.15962","article-title":"Evaluation of the SAVI SCOUT Surgical Guidance System for Localization and Excision of Nonpalpable Breast Lesions: A Feasibility Study","volume":"207","author":"Mango","year":"2016","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1148\/radiol.2017161661","article-title":"Beyond Wires and Seeds: Reflector-Guided Breast Lesion Localization and Excision","volume":"284","author":"Mango","year":"2017","journal-title":"Radiology"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.2214\/AJR.08.1023","article-title":"Radiofrequency Identification Tags for Preoperative Tumor Localization: Proof of Concept","volume":"191","author":"Reicher","year":"2008","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"872","DOI":"10.2214\/AJR.14.12743","article-title":"Radioactive Seed Localization versus Wire Localization for Lumpectomies: A Comparison of Outcomes","volume":"204","author":"Sharek","year":"2015","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1002\/bjs.9962","article-title":"Radioactive Seed Localization in Breast Cancer Treatment","volume":"103","author":"Janssen","year":"2016","journal-title":"Br. J. Surg."},{"key":"ref_78","first-page":"20584601221088920","article-title":"Radioactive Seed Localization of Foreign Body","volume":"11","author":"Hylenius","year":"2022","journal-title":"Acta Radiol. Open"},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Banys-Paluchowski, M., K\u00fchn, T., Masannat, Y., Rubio, I., de Boniface, J., Ditsch, N., Karadeniz Cakmak, G., Karakatsanis, A., Dave, R., and Hahn, M. (2023). Localization Techniques for Non-Palpable Breast Lesions: Current Status, Knowledge Gaps, and Rationale for the MELODY Study (EUBREAST-4\/IBRA-NET, NCT 05559411). Cancers, 15.","DOI":"10.3390\/cancers15041173"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.1245\/s10434-015-5052-8","article-title":"Axillary Staging After Neoadjuvant Chemotherapy for Breast Cancer: A Pilot Study Combining Sentinel Lymph Node Biopsy with Radioactive Seed Localization of Pre-Treatment Positive Axillary Lymph Nodes","volume":"23","author":"Diego","year":"2016","journal-title":"Ann. Surg. Oncol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1007\/s00259-002-0936-9","article-title":"Radioguided Localisation of Non-Palpable Breast Lesions and Simultaneous Sentinel Lymph Node Mapping","volume":"29","author":"Barros","year":"2002","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1016\/j.crad.2004.12.004","article-title":"Radio-Guided Localization of Clinically Occult Breast Lesions (ROLL): A DGH Experience","volume":"60","author":"Thind","year":"2005","journal-title":"Clin. Radiol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.breast.2005.04.002","article-title":"Occult Breast Lesions: A Comparison between Radioguided Occult Lesion Localisation (ROLL) vs. Wire-Guided Lumpectomy (WGL)","volume":"14","author":"Nadeem","year":"2005","journal-title":"Breast"},{"key":"ref_84","first-page":"145","article-title":"Radioguided Occult Lesion Localisation (ROLL) and Surgical Biopsy in Breast Cancer. Technical Aspects","volume":"46","author":"Pizzamiglio","year":"2002","journal-title":"Q. J. Nucl. Med. Off. Publ. Ital. Assoc. Nucl. Med. AIMN Int. Assoc. Radiopharmacol. IAR"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/S0960-9776(02)00265-5","article-title":"Radioisotope for Occult Lesion Localisation (ROLL) of the Breast Does Not Require Extra Radiation Protection Procedures","volume":"12","author":"Rampaul","year":"2003","journal-title":"Breast"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.breast.2010.01.017","article-title":"Radioguided Occult Lesion Localization (ROLL) for Non-Palpable Breast Cancer: A Comparison between Day-before and Same-Day Protocols","volume":"19","author":"Aydogan","year":"2010","journal-title":"Breast"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1007\/s12149-009-0259-z","article-title":"Comparison of Subareolar Injection Lymphoscintigraphy with the 1-Day and the 2-Day Protocols for the Detection of Sentinel Lymph Nodes in Patients with Breast Cancer","volume":"23","author":"Seok","year":"2009","journal-title":"Ann. Nucl. Med."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1111\/j.1524-4741.2007.00448.x","article-title":"Radioguided Localization of Clinically Occult Breast Lesions (ROLL): A Pilot Study","volume":"13","author":"Romero","year":"2007","journal-title":"Breast J."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/j.breast.2008.05.005","article-title":"Recurrence after ROLL Lumpectomy for Invasive Breast Cancer","volume":"17","author":"Ramesh","year":"2008","journal-title":"Breast"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1245\/s10434-006-9070-4","article-title":"Sentinel Node Biopsy and Concomitant Probe-Guided Tumor Excision of Nonpalpable Breast Cancer","volume":"14","author":"Tanis","year":"2007","journal-title":"Ann. Surg. Oncol."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/j.breast.2009.08.002","article-title":"Factors Correlated to Successful Surgical Treatment of 181 Non-Palpable Invasive Breast Carcinomas","volume":"18","author":"Besic","year":"2009","journal-title":"Breast"},{"key":"ref_92","first-page":"385","article-title":"Radioguided Occult Lesion Localization (ROLL) of the Nonpalpable Breast Lesions","volume":"51","author":"Zgajnar","year":"2004","journal-title":"Neoplasma"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1186\/s13550-019-0560-3","article-title":"Feasibility of Radioguided Occult Lesion Localization of Clip-Marked Lymph Nodes for Tailored Axillary Treatment in Breast Cancer Patients Treated with Neoadjuvant Systemic Therapy","volume":"9","author":"Hellingman","year":"2019","journal-title":"EJNMMI Res."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/j.rpor.2020.04.022","article-title":"Is SNOLL a Good Localization Technique in Early Breast Cancer Treatment? A Single Center\u2019s Experience","volume":"25","author":"Adamczyk","year":"2020","journal-title":"Rep. Pract. Oncol. Radiother."},{"key":"ref_95","first-page":"1207","article-title":"First Reported Use of Radiofrequency Identification (RFID) Technique for Targeted Excision of Suspicious Axillary Lymph Nodes in Early Stage Breast Cancer\u2014Evaluation of Feasibility and Review of Current Recommendations","volume":"34","author":"Malter","year":"2020","journal-title":"Vivo Athens Greece"},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"den Dekker, B.M., Christenhusz, A., van Dalen, T., Jongen, L.M., van der Schaaf, M.C., Dassen, A.E., and Pijnappel, R.M. (2022). A Multicenter Prospective Cohort Study to Evaluate Feasibility of Radio-Frequency Identification Surgical Guidance for Nonpalpable Breast Lesions: Design and Rationale of the RFID Localizer 1 Trial. BMC Cancer, 22.","DOI":"10.1186\/s12885-022-09394-7"},{"key":"ref_97","first-page":"233","article-title":"Wireless Breast Localization Using Radio-Frequency Identification Tags: The First Reported European Experience in Breast Cancer","volume":"34","author":"Wazir","year":"2020","journal-title":"Vivo Athens Greece"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1016\/j.crad.2020.08.014","article-title":"Use of Hologic LOCalizer Radiofrequency Identification (RFID) Tags to Localise Impalpable Breast Lesions and Axillary Nodes: Experience of the First 150 Cases in a UK Breast Unit","volume":"75","author":"Lowes","year":"2020","journal-title":"Clin. Radiol."},{"key":"ref_99","first-page":"2342","article-title":"Evaluation of a Wireless Localization System for Nonpalpable Breast Lesions\u2014Feasibility and Cost-Effectiveness in Everyday Clinical Routine","volume":"36","author":"Heindl","year":"2022","journal-title":"Vivo Athens Greece"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/15\/7\/2130\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:09:06Z","timestamp":1760123346000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/15\/7\/2130"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,3]]},"references-count":99,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["cancers15072130"],"URL":"https:\/\/doi.org\/10.3390\/cancers15072130","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,3]]}}}