Jul 25, 2025 8:20:30 AM
Targeted axillary dissection is a hybrid surgical technique used in breast cancer treatment to improve staging accuracy after neoadjuvant systemic therapy. It involves removing both the sentinel lymph node and a previously biopsied, marked metastatic lymph node. Targeted axillary dissection allows for precise axillary assessment while reducing the need for full axillary lymph node dissection. In this blog, we explain how the procedure works, what the benefits are, and how magnetic localization technologies like Pintuition® can support this approach.
What is targeted axillary dissection?
Targeted axillary dissection is a surgical technique that combines two procedures: the sentinel lymph node biopsy and the removal of a previously biopsied and marked metastatic lymph node. This combination enhances staging accuracy while helping patients avoid a full axillary lymph node dissection, which is known to carry a higher risk of complications.
Targeted axillary dissection is typically performed after neoadjuvant systemic therapy. During treatment planning, the marked node is identified using localization technologies such as permanent magnetic systems.
This procedure is part of a broader movement in breast cancer surgery that focuses on de-escalation. The goal is to achieve the same or better clinical outcomes with fewer invasive procedures. Sentinel lymph node dissection plays an important role in this shift as well.
Read more: Discover more about sentinel lymph node dissection
How targeted axillary dissection is performed?
The procedure begins before the start of neoadjuvant systemic therapy, when a lymph node known to contain cancer is identified and marked. This marking can be done using a variety of localization tools, including a clip, an iodine seed, a radar reflector, or a permanent magnetic marker. These markers ensure the metastatic node can be located again later during surgery.
Once therapy is complete, the surgeon removes both the sentinel lymph node and the previously marked metastatic node. This dual-node removal provides an accurate pathological restaging of the axilla and helps determine whether the cancer has responded to treatment or has progressed.
Successful targeted axillary dissection relies on accurate localization and strong coordination between radiology and surgery. Tools like Sirius Pintuition® powered by GPSDetect® software support this process by providing real-time distance and directional guidance, helping the surgeon precisely locate and retrieve the marked node during the procedure.
Clinical benefits and accuracy
Research shows that the false-negative rate in axillary staging drops to around 2.4% when both the sentinel node and the marked node are removed, and more than three lymph nodes are examined. This significantly improves the accuracy of the staging process. Benefits of this approach include:
- Avoidance of full axillary lymph node dissection
- Reduced risk of post-surgical complications such as lymphedema, sensory nerve injury, and shoulder dysfunction
- Faster and more comfortable recovery
- Support for personalized treatment planning, enabling tailored follow-up care and therapy
Clinical trials and systematic reviews continue to demonstrate the high accuracy of targeted axillary dissection in carefully selected patient groups.
Sirius Medical's contribution
Sirius Medical supports targeted axillary dissection with Sirius Pintuition®, a wire-free system that uses permanent magnetic markers for accurate lymph node localization. Powered by GPSDetect™, it offers real-time directional and distance feedback with visual and audio guidance. The TargetLOC™ feature confirms perfect alignment of the probe with the marker, enabling precise and efficient node retrieval. This integrated, radiation-free workflow streamlines coordination from biopsy to surgery, improving accuracy and reducing complexity.
Discover the Sirius Pintuition® solution for node localization
Disclaimer
This article is intended for informational purposes only and should not be considered medical advice. While Sirius Medical is dedicated to improving breast cancer treatment through innovative localization technology, we do not provide medical diagnoses or treatment recommendations. If you experience any symptoms or changes in your breast health, consult a qualified healthcare professional promptly. Early medical evaluation is crucial for accurate diagnosis and effective treatment. Always seek professional guidance for concerns regarding your health.