Preoperative localization of positive lymph nodes in breast cancer with iodine-125 seeds guided by computed tomography
Marcelo E. Muñoz 1, Luciano E. Mignini 2, María S. Muñoz 1, Daniela A. Muñoz 1, María L. Alvares 1, Carlos E. Rossi† 3, Andrea Tuells 4, Noelia Fantasía 5
1 Servicio de Diagnóstico Mamario, Cámara Gamma Rosario (CGR) Imágenes Médicas, CGR Imágenes Médicas. Rosario, Santa Fe, Argentina; 2 Unidad de Mastología, Grupo Oroño, CGR Imágenes Médicas. Rosario, Santa Fe, Argentina; 3 Servicio de Medicina Nuclear, CGR Imágenes Médicas. Rosario, Santa Fe, Argentina; 4 Servicio de Tomografía Computada, CGR Imágenes Médicas. Rosario, Santa Fe, Argentina; 5 Servicio de Intervencionismo mamario, CGR Imágenes Médicas. Rosario, Santa Fe, Argentina
*Correspondence: Marcelo E. Muñoz. Email: memfster@gmail.com
Abstract
The successive changes in the management of the axilla as part of the surgical treatment of breast cancer, currently converge in the targeted axillary dissection as surgical conduct in those patients with level I and II axillary nodes with proven metastasis and who have responded to neoadjuvant chemotherapy. The widespread use of neoadjuvant chemotherapy is aimed at reducing the tumor mass in the breast and axillary nodes and in the face of a satisfactory response, difficulties may arise in its preoperative localization in spite of having placed a clip during the biopsy with ultrasound. In our environment, the preoperative localization is performed with radioactive iodine-125 seeds. We present the preoperative localization of positive lymph nodes biopsied under ultrasound in breast cancer stages cT1-4/cN1/cM0 in 9/16 patients who received neoadjuvant chemotherapy with complete imaging response in which the identification of the positive biopsied node or its clip was difficult with ultrasound, so CT-guided marking was used which detected the metallic clip without limitations.
