Evidence map›Paper›PMID 39976867›Full record

ArticleBreast cancer research and treatment2025

Radar reflectors for marking of target lymph nodes in initially node-positive patients receiving neoadjuvant chemotherapy for breast cancer-a subgroup analysis of the prospective AXSANA (EUBREAST-03) trial.

Maggie Banys-Paluchowski, Steffi Hartmann, Timo Basali, Maria Luisa Gasparri, Jana de Boniface, Oreste Davide Gentilini, Güldeniz Karadeniz Cakmak, Nina Ditsch, Elmar Stickeler, Ellen Schlichting and 36 more

Registry-linked trialAbstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Breast cancer research and treatment, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04373655 (A Prospective Multicenter Cohort Study to Evaluate Different Surgical Methods of Axillary Staging), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT04373655 recruitingnot on this map

A Prospective Multicenter Cohort Study to Evaluate Different Surgical Methods of Axillary Staging (sentinel Lymph Node Biopsy, Targeted Axillary Dissection, Axillary Dissection) in Clinically Node-positive Breast Cancer Patients Treated with Neoadjuvant Chemotherapy

Typeobservational_patient_registrySponsorEuropean Breast Cancer Research Association of Surgical TrialistsRan2020 to 2030Enrolled3,000ConditionsBreast Cancer
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. RADar Reflector LocalisatIOn-SCOUTAnnals of surgical oncology · 2026
    Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

46 authors.

Maggie Banys-Paluchowski *Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein, Campus Lübeck, Lubeck, Germany. Maggie.Banys-Paluchowski@uksh.de.
Steffi Hartmann *Department of Gynecology and Obstetrics, University Hospital Rostock, Rostock, Germany.
Timo BasaliDepartment of Gynecology and Obstetrics, Hospital Esslingen, Esslingen, Germany.
Maria Luisa GasparriDepartment of Gynecology and Obstetrics, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale, Lugano, Switzerland.
Jana de BonifaceDepartment of Surgery, Breast Center, Capio St. Göran's Hospital, Stockholm, Sweden.
Oreste Davide GentiliniBreast Surgery Unit, Universita Vita-Salute San Raffaele, Milan, Italy.
Güldeniz Karadeniz CakmakBreast and Endocrine Unit, General Surgery Department, Zonguldak BEUN The School of Medicine, Zonguldak, Turkey.
Nina DitschGynecology, Obstetrics and Senology, Faculty of Medicine, University Hospital Augsburg, University of Augsburg, Augsburg, Germany.
Elmar StickelerDepartment of Gynecology and Obstetrics, University Hospital Aachen, Aachen, Germany.
Ellen SchlichtingDepartment of Oncology, Oslo University Hospital, Oslo, Norway.
Isabel RubioBreast Surgical Unit, Clínica Universidad de Navarra, Madrid, Spain.
Florentia PeintingerDepartment of Gynecology and Obstetrics, University Hospital Graz, Graz, Austria.
Michael UntchDepartment of Obstetrics and Gynecology, Helios Hospital Berlin-Buch, Buch, Berlin, Germany.
Christine MauDepartment of Obstetrics and Gynecology, Helios Hospital Berlin-Buch, Buch, Berlin, Germany.
Frederike Klaassen FederspielDepartment of Senology, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
Susanne BucherBreast Center, Cantonal Hospital Luzern, Lucerne, Switzerland.
Kerstin RamakerBreast Center Pinneberg, Regio Hospitals, Pinneberg, Germany.
Peter PaluchowskiBreast Center Pinneberg, Regio Hospitals, Pinneberg, Germany.
Lelia BauerDepartment of Obstetrics and Gynecology, GRN Hospital Weinheim, Weinheim, Germany.
Sabine RiemerDepartment of Obstetrics and Gynecology, St. Joseph Stift Bremen, Bremen, Germany.
Dagmar LangankeDepartment of Senology and Breast Center, St. Elisabeth Hospital, Leipzig, Germany.
Tanja Durpektova LeufDepartment of Gynecology and Breast Center, Asklepios Hospital, Weissenfels, Germany.
Jens SchnabelDepartment of Obstetrics and Gynecology, DRK Hospital Chemnitz Rabenstein, Chemnitz, Germany.
Ekkehard von AbelDepartment of Obstetrics and Gynecology, Staufer Hospital Mutlangen, Mutlangen, Germany.
Christine SolbachDepartment of Obstetrics and Gynecology, University Hospital Frankfurt, Frankfurt, Germany.
Sonja Cáradenas OvalleDepartment of Gynecology, Protestant Forest Hospital Spandau, Spandau, Germany.
Kerstin HilmerDepartment of Obstetrics and Gynecology, Helios Hospital Gifhorn GmbH, Gifhorn, Germany.
Vesna Bjelic-RadisicBreast Center, Helios University Hospital, Wuppertal, Germany.
Nicole StahlBreast Center, Helios Hospital Schwerin, Schwerin, Germany.
Jose I Sanchez-MendezDepartment of Gynecology, Hospital Universitario La Paz, Madrid, Spain.
Vibeke HagenDepartment of Gynecology, St. Olavs Hospital, Trondheim, Norway.
Marit Helene HansenDepartment of Breast and Endocrine Surgery, The Arctic University of Norway, Tromsoe, Norway.
Natalia KrawczykDepartment of Obstetrics and Gynecology, University Hospital Düsseldorf, Dusseldorf, Germany.
Bilge Aktas SezenEUBREAST e.V., Esslingen, Germany.
Katharina JursikEUBREAST e.V., Esslingen, Germany.
Marc ThillDepartment of Gynecology and Gynecological Oncology, Agaplesion Markus Hospital, Frankfurt, Germany.
Hans-Christian KolbergDepartment of Gynecology and Obstetrics, Marienhospital Bottrop, Bottrop, Germany.
Toralf ReimerDepartment of Gynecology and Obstetrics, University Hospital Rostock, Rostock, Germany.
Franziska RufDepartment of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein, Campus Lübeck, Lubeck, Germany.
Kristina WihlfahrtPractice for Gynecology and Obstetrics Wihlfahrt, Kiel, Germany.
Angelika RiefDepartment of Gynecology and Obstetrics, Medical University of Graz, Graz, Austria.
Tomasz BergerDepartment of Gynecology and Obstetrics, Müritz-Klinikum Waren, Waren, Germany.
Esther SchmidtDepartment of Gynecology and Obstetrics, University Hospital Rostock, Rostock, Germany.
Nikolas TauberDepartment of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein, Campus Lübeck, Lubeck, Germany.
Sarah FröhlichDepartment of Gynecology and Obstetrics, University Hospital Rostock, Rostock, Germany.
Thorsten KühnDepartment of Gynecology and Obstetrics, University of Ulm, Ulm, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSurgical staging procedures of the axilla in initially clinically node-positive (cN +) breast cancer patients receiving neoadjuvant chemotherapy (NACT) vary across countries. Different procedures such as axillary lymph node dissection, sentinel lymph node biopsy, target lymph node biopsy and targeted axillary dissection are currently in use. To date, data on radar reflectors as a non-wire and non-radioactive technique for marking target lymph nodes are limited. The present study aims at examining the detection rate, the rate of lost markers, and magnetic resonance imaging artifacts after TLN marking using a radar reflector before NACT in the largest available cohort of breast cancer patients enrolled in the international prospective AXSANA study.

methodsAXSANA (EUBREAST-03) is an international prospective cohort study including cN + patients managed with different surgical axillary staging techniques after NACT. Eligible patients have cT1-4c cN + breast cancer and receive neoadjuvant chemotherapy. Patients are followed up for 5 years. In the present subgroup analysis, only patients with a TLN marked by a radar reflector were included.

resultsA TLN was marked by radar reflector insertion in 158 patients prior to NACT. Of these, 136 had final surgery results available at the time of analysis, and in 135 out of these 136 patients, localization of TLN was attempted. All radar markers were successfully removed. While lymphoid tissue corresponding to the TLN was identified in 132 patients (97.8%), no lymphoid tissue was detected on histopathology in three patients. It remains unclear whether the TLN was excised in these cases or not. In 1 out of 27 patients (3.7%) who underwent preoperative MRI, image assessment was compromised due to artifacts after radar marker placement.

conclusionTo the best of our knowledge, this is the largest prospective series of patients receiving a radar reflector for the marking of a TLN prior to NACT for breast cancer. Our data demonstrate that radar reflectors are a reliable tool for marking target lymph nodes before neoadjuvant treatment. TRIAL REGISTRATION NUMBER: NCT04373655 (date of registration May 4, 2020).

Indexed as

Breast NeoplasmsLymph NodesRadarAdultAgedAxillaFemaleHumansLymphatic MetastasisLymph Node ExcisionMagnetic Resonance ImagingMiddle AgedNeoadjuvant TherapyNeoplasm StagingProspective StudiesSentinel Lymph Node BiopsyBreast cancerNeoadjuvant chemotherapyRadar reflectorRecurrenceTargeted axillary dissectionTarget lymph node

Identifiers

PMID39976867

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