目标性腋窝清扫术(TAD)，在新辅助化疗(NACT)前标记转移淋巴结的方法越来越被用于乳腺癌腋窝分期。在腋窝病理完全缓解(ax-pCR)的情况下，可以省略腋窝淋巴结清除。存在多种标记方法，其中大多数使用手术前再次标记。可行性、学习曲线和鉴别率(IR)有所不同。在NACT前使用125I种子进行标记，可以使手术时再次标记变得多余，可能提高了可行性和鉴别率。在丹麦多中心队列中评估了在NACT前用125I种子放置的TAD。收纳了2016年1月1日至2021年8月31日在丹麦接受125I TAD分期的患者。患者的病历信息从放射科和丹麦乳腺癌组数据库的放射性植入物登记中提取。记录了患者/肿瘤特征、125I种子活性、标记期间、TAD成功率、标志淋巴结(SNs)的数量、切除淋巴结的病理学状态以及标记淋巴结(MLN)是否是SN。共计收纳了142位患者。MLN的IR为99.3%，SNB的IR为91.5%。TAD成功率为91.5%。三个患者在标记或切除MLN时遇到了轻微的困难。在72.3%的患者中，MLN是一个Sentinel node。总体而言，40.8%的患者有腋窝pCR。在NACT前使用125I种子进行标记的TAD是可行的，不需要手术时再次标记，并且只有少量的手术难度。鉴别率很高。使用TAD分期可以使41%的乳腺癌患者避免腋窝清扫术。 ©2023. 作者。

Targeted axillary dissection (TAD), with marking of the metastatic lymph node before neoadjuvant chemotherapy (NACT), is increasingly used for breast cancer axillary staging. In the case of axillary pathological complete response (ax-pCR), axillary lymph node clearance can be omitted. Several marking methods exist, most using re-marking before surgery. Feasibility, learning curve, and identification rate (IR) vary. Marking with 125I seed before NACT makes re-marking at surgery redundant, possibly increasing feasibility and IR. Here, TAD with 125I seed placed before NACT is evaluated in a Danish multicenter cohort.Patients staged with 125I TAD in Denmark between 1 January 2016 and 31 August 2021 were included. Patients were identified in radioactivity-emitting implant registries at the radiology departments and from the Danish Breast Cancer Group database. Data were extracted from patients' medical records. Information on patient/tumor characteristics, 125I seed activity, marking period, TAD success, number of sentinel nodes (SNs), the histopathological status of excised nodes, and whether the marked lymph node (MLN) was an SN were registered.142 patients were included. The IR of the MLN was 99.3%, and the IR of the SLNB was 91.5%. TAD success was 91.5%. Minor challenges in marking or removal of the MLN were noted in three patients. In 72.3% of the patients, the MLN was a sentinel node. Overall, 40.8% had axillary pCR.TAD with 125I seed marking before NACT is feasible without re-marking at surgery and with only minor surgical challenges. The IR is high. Staging with TAD spares 41% of breast cancer patients an axillary dissection.© 2023. The Author(s).