SAVI SCOUT®or radar reflector localisation (RRL) has proven accurate in localising non-palpable breast and axillary lesions, with minimal interference with MRI. Targeted axillary dissection (TAD), combining marked lymph node biopsy (MLNB) and sentinel lymph node biopsy (SLNB), is becoming a standard post-neoadjuvant systemic therapy (NST) for node-positive early breast cancer. Compared to SLNB alone, TAD reduces the false negative rate (FNR) to below 6%, enabling safer axillary surgery de-escalation. This systematic review evaluates RRL’s performance during TAD, assessing localisation and retrieval rates, the concordance between MLNB and SLNB, and the pathological complete response (pCR) in clinically node-positive patients post-NST. Four studies (252 TAD procedures) met the inclusion criteria, with a 99.6% (95% confidence [CI]: 98.9–100) successful localisation rate, 100% retrieval rate, and 81% (95% CI: 76–86) concordance rate between SLNB and MLNB. The average duration from RRL deployment to surgery was 52 days (range:1–202). pCR was observed in 42% (95% CI: 36–48) of cases, with no significant migration or complications reported. Omitting MLNB or SLNB would have under-staged the axilla in 9.7% or 3.4% (p= 0.03) of cases, respectively, underscoring the importance of incorporating MLNB in axillary staging post-NST in initially node-positive patients in line with the updated National Comprehensive Cancer Network (NCCN) guidelines. These findings underscore the excellent efficacy of RRL in TAD for NST-treated patients with positive nodes, aiding in accurate axillary pCR identification and the safe omission of axillary dissection in strong responders.
SAVI SCOUT®或雷达反射体定位（RRL）技术已被证实能准确定位不可触及的乳腺及腋窝病灶，且对磁共振成像干扰极小。靶向腋窝淋巴结清扫术（TAD）结合标记淋巴结活检（MLNB）与前哨淋巴结活检（SLNB），正逐渐成为淋巴结阳性早期乳腺癌新辅助系统治疗（NST）后的标准术式。与单纯SLNB相比，TAD能将假阴性率（FNR）降至6%以下，为安全实施降级腋窝手术创造条件。本系统综述评估了RRL在TAD中的应用效果，包括定位与检出率、MLNB与SLNB的一致性，以及NST后临床淋巴结阳性患者的病理完全缓解（pCR）情况。四项研究（共252例TAD手术）符合纳入标准，结果显示：定位成功率达99.6%（95%置信区间[CI]：98.9–100），检出率为100%，SLNB与MLNB的一致率为81%（95% CI：76–86）。从RRL置入至手术的平均时长为52天（范围：1–202天）。42%（95% CI：36–48）的病例达到pCR，且未报告显著移位或并发症。若省略MLNB或SLNB，将分别导致9.7%或3.4%（p=0.03）的病例腋窝分期不足，这凸显了根据美国国家综合癌症网络（NCCN）更新指南，在初始淋巴结阳性患者NST后腋窝分期中纳入MLNB的重要性。这些发现证实了RRL在NST治疗后淋巴结阳性患者TAD中的卓越效能，有助于准确识别腋窝pCR，并为强反应者安全豁免腋窝淋巴结清扫提供依据。
肿瘤(癌症)患者之家