Tumark® Vision Atlas
A 45 year-old patient with right-axillary lymph node suggestive of metastasis detected in ultrasound
Dr. S. Metz, Institute for Diagnostic and Interventional Radiology at the Technical University of Munich, Klinikum Rechts der Isar, Munich, Germany
A right-axillary lymph node, suggestive of metastasis, was detected in an ultrasound. Initially, an ultrasound-guided punch biopsy of the lymph node detected cancerous cells. PET-CT and breast MRI for staging followed. Second ultrasound and sonobiopsy of the inside-right of the breast: NST, G3, HR negative; HER2-immunohistochemistry: 3+.
Course of treatment
The primary tumor and right-axillary lymph node clip marked with Tumark Vision. Primary systemic therapy initiated, consisting of 4 x EC followed by 12 x trastuzumab + pertuzumab weekly. Following primary systemic therapy (PST), complete remission (CR) shown in the imaging.
A treatment option analogous to the course of action suggested in the SenTa study would be a suitable option for the case presented. The hospitals “Kliniken Essen-Mitte” (Kümmel S. et al.) have initiated this study, which is a prospective, multi-centric registry on the usage frequency and feasibility of targeted axillary dissection in patients with primary breast cancer and PST, in whom a punch biopsy is initially performed and the clinically suspicious lymph node is marked with a clip. The primary study goal defined is the identification of the surgical detection rate of the target lymph node (TLNB) marked with a clip. In this context, distinguishing of the clip via ultrasound for pre-operative marking is of crucial importance.