الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 152 |  |  |
| | | from | 152 | | |
Abstract
The study evaluated the feasibility and accuracy of targeted lymph node (LN) localization in patients with clipped lymph nodes who underwent neoadjuvant chemotherapy. Among the 25 patients who underwent targeted LN dissection, 96% successfully achieved intra-operative localization of the clipped lymph node by pulling on the guide wire.
Only one patient experienced a slip of the wire from the clipped lymph node, resulting in failed localization and identification of the metallic clip on the excised lymph node. However, this patient’s axillary clearance of level 1 and 2 lymph nodes was proven to be negative on histopathology.
Furthermore, 20% of the patients had the clipped lymph node identified as the sentinel lymph node (SLN), indicating that sentinel lymph node biopsy alone is not a sufficient alternative to targeted axillary dissection.
Only two patients (8.33%) had positive histopathology results, indicating a false negative rate of 8.33%. These patients received axillary radiotherapy and showed no recurrence during the 6-month follow-up period of the study.
Based on these findings, targeted LN localization is considered a feasible and accurate technique for identifying the SLN in patients with clipped lymph nodes who achieved a complete pathological response to neoadjuvant chemotherapy.
The procedure demonstrated a high success rate and acceptable false negative rate. The results suggest that targeted LN localization can be an effective approach in guiding surgical decisions and optimizing treatment strategies for this patient population.
In conclusion, this study provides evidence supporting the use of targeted LN localization as a reliable method for identifying the sentinel lymph node in patients with clipped lymph nodes who have undergone neoadjuvant chemotherapy. The high success rate of 96% in achieving localization of the clipped lymph node indicates the feasibility and effectiveness of this technique. The acceptable false negative rate further support its accuracy in guiding surgical interventions.
In this study identifying the clipped Lymph node within the sentinel lymph node was found in only 20% of the cases, highlighting the magnitude of adding TAD to the classical SLNB approach.
Although two patients showed false negative results on histopathology, their subsequent treatment with axillary radiotherapy resulted in no recurrence during the 6-month follow-up period. This suggests that targeted LN localization can help identify potential false negative cases, enabling appropriate adjuvant therapies to be administered, thereby improving patient outcomes.
Overall, targeted LN localization has the potential to inform surgical decision-making and optimize treatment strategies in patients with clipped lymph nodes who have achieved a complete pathological response to neoadjuvant chemotherapy. Further research and larger-scale studies are warranted to validate these findings and explore the long-term implications of this technique.