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Background: In early-stage breast cancer with initially positive axillary lymph nodes, reliable assessment of the involvement of the axilla is important because of the prognostic importance of lymph-node metastases. After neoadjuvant chemotherapy (NACT) targeted axillary dissection (TAD) including sentinel lymph-node biopsy and primarily involved lymph nodes, is currently regarded as the standard of care. The target lymph node must be marked using a clip/marker and later localized using a reliable guidance technique to identify the node to avoid the indication of axillary lymph-node dissection. Methods: The present study aimed to evaluate retrospective data collected from April 25th, 2022, until March 30th, 2023, on a consecutive series of patients, to determine the efficacy and safety of using the Sirius Pintuition GPSDetect™ surgical marker navigation system. Results: This case series shows that identification of the target node with surgical marker navigation is feasible and safe with a 100% identification rate at surgery, in a population of patients with histologically verified axillary lymph-node involvement before NACT. Conclusion: Magnetically guided localization systems may therefore be a valid alternative to ultrasound-guided wire placement. The data highlights the practicality of the magnetically guided approach, which potentially contributes to a reduction in treatment related morbidity by avoiding unnecessary axillary lymph node dissection.

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