Trial reportCancer medicine2020
Initial results of a novel technique of clipped node localization in breast cancer patients postneoadjuvant chemotherapy: Skin Mark clipped Axillary nodes Removal Technique (SMART trial).
Trial report in Cancer medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Diagnostic accuracy of de-escalated surgical procedure in axilla for node-positive breast cancer patients treated with neoadjuvant systemic therapy: A systematic review and meta-analysis.Cancer medicine · 2022Pooled it
- Initial results of a novel technique of clipped node localization in breast cancer patients postneoadjuvant chemotherapy: Skin Mark clipped Axillary nodes Removal Technique (SMART trial).Cancer medicine · 2020Trial
- Comparison of ultrasound visibility and retrieval success of two ultrasound-visible clips in targeted axillary dissection after neoadjuvant chemotherapy.Breast cancer (Tokyo, Japan) · 2026Article
- Ultrasound-only localisation of a non-palpable cervical lymph node using an UltraCor™ marker for surgical diagnosis of relapsed Hodgkin lymphoma: a case report.Journal of ultrasound · 2026Article
- Titanium clip for lymph node marking in node-positive breast cancer: a reliable, cost-effective approach to targeted axillary dissection following neoadjuvant chemotherapy.Ecancermedicalscience · 2026Article
- Article
- Targeted axillary dissection in breast cancer patients with metastatic nodal disease: a prospective study on localization techniques and oncological outcomes.Gland surgery · 2025Article
- Article
- Safety Clearance and Artifact Testing of a Nitinol Breast Biopsy Clip in an Ultra-High Resolution (7 Tesla) Magnetic Resonance Imaging Environment.The Indian journal of radiology & imaging · 2025Article
- Ultrasonographic accuracy in evaluating response of clipped lymph nodes in targeted axillary dissection in breast cancer.Scientific reports · 2025Article
- Use of axillary ultrasound to guide breast cancer management in the genomic assay era.Breast disease · 2024Article
- Comparing Methods for Targeted Axillary Dissection in Breast Cancer Patients: A Nationwide, Retrospective Study.Annals of surgical oncology · 2023Article
- An unusual site for breast clip migration: A case report.Radiology case reports · 2023Article
- Axillary management of breast cancer patients with isolated chest wall recurrence after mastectomy.Annals of translational medicine · 2023Article
- Article
- Marking Techniques for Targeted Axillary Dissection Among Patients With Node-Positive Breast Cancer Treated With Neoadjuvant Chemotherapy.Breast cancer : basic and clinical research · 2023Review
- Feasibility and accuracy of targeted axillary dissection in breast cancer patients; single center experience.Frontiers in surgery · 2023Article
- Comparison of the Ultrasound Visibility of Tissue Markers in Metastatic Lymph Nodes after Neoadjuvant Chemotherapy in Patients with Breast Cancer.Diagnostics (Basel, Switzerland) · 2022Article
- Determining the benefit of neoadjuvant chemotherapy in reduction of axillary dissection rates in Z0011 trial cohort with high nodal burden.Gland surgery · 2022Article
- Surgery after Neoadjuvant Chemotherapy: A Clip-Based Technique to Improve Surgical Outcomes, a Single-Center Experience.Cancers · 2022Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeRemoval of clipped nodes can improve sentinel node biopsy accuracy in breast cancer patients post neoadjuvant chemotherapy (NACT). However, the current methods of clipped node localization have limitations. We evaluated the feasibility of a novel clipped node localization and removal technique by preoperative skin marking of clipped nodes and removal by the Skin Mark clipped Axillary nodes Removal Technique (SMART), with the secondary aim of assessing the ultrasound visibility of the various clips in the axillary nodes after NACT.
methodsInvasive breast cancer patients with histologically metastatic axillary nodes, going for NACT, and ≤3 sonographically abnormal axillary nodes were recruited. All abnormal nodes had clips inserted. Patients with M1 disease were excluded. Post-NACT, patients underwent SMART and axillary lymph node dissection. Specimen radiography and pathological analyses were performed to confirm the clipped node presence. Success, complication rates of SMART, and ultrasound visibility of the various clips were assessed.
resultsTwenty-five clipped nodes in 14 patients underwent SMART without complications. The UltraCor Twirl, hydroMARK, UltraClip Dual Trigger, and UltraClip were removed in 13/13 (100%), 7/9 (77.8%), 1/2 (50.0%), and 0/1 (0%), respectively (P = .0103) with UltraCor Twirl having the best ultrasound visibility and removal rate. Removal of three clipped nodes in the same patient (P = .0010) and deeply seated clipped nodes (P = .0167) were associated with SMART failure.
conclusionSkin Mark clipped Axillary nodes Removal Technique is feasible for removing clipped nodes post-NACT, with 100% observed success rate, using the UltraCor Twirl marker in patients with <3 not deeply seated clipped nodes. Larger studies are needed for validation.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.