Table 1.

Reported FNRs of TAD

First author [ref.], year	Populationa, n	FNR	Comments
Reinisch [5], 2019	45	FNR of TAD = 4.4% FNR of marked node only = 8%	The only multicenter prospective study (SENTA) with 598 patients, 45 of whom were used for the FNR of TAD calculation
Kim [6], 2019	15	FNR of TASb = 80% FNR of marked node biopsy or tattooed node biopsy = 67% for either	28 cytologically proven N+ breast cancer patients underwent dual localization of axillary nodes before and after NAC with clip and activated charcoal At restaging US, 5 patients had suspicious nodes and 23 had no suspicious nodes Clipped node biopsy failed in 1 patient and tattooed node biopsy in none 20 patients underwent TAS and 8 underwent ALND
Kim [7], 2018	18	FNR of TASb = 0 FNR of tattooed node biopsy only = 33%	45 patients treated with NAC with <2 suspicious nodes at post-NAC restaging US All patients had clinically node-positive disease at initial staging and underwent post-NAC localization of the most suspicious axillary lymph node with activated charcoal Patients received TAS, extended TAS, or ANC. In 1 patient, the surgeon could not find the tattooed node
Donker [8], 2015	95	7% of the MARI node biopsy only	Only MARI node biopsy was performed All patients were treated with ANC The marked node was identified in 97 patients 2 patients did not undergo subsequent ALND, leaving 95 patients for further analysis.
Lim [9], 2020	14	FNR of TAD with 1 marked node = 7.1% FNR of TAD with 2 marked nodes = 0%	No SNB was done 9, 3, and 2 patients had 1, 2, and 3 positive nodes clipped, respectively
Hartmann [10], 2018	17	0% of marked node biopsy only	30 patients were marked, 25 of whom were N+ All patients underwent completion ALND, and, if yiN0, SNB Wire localization of the marked nodes was possible in 24/30 patients, and the clip was inside the marked node specimen in 17/24 cases
Khallaf [12], 2020	19	8.3%	20 patients had locally advanced disease with N0 axilla after NAC and received ANC at surgery The marked node was identified in 19 patients
García-Moreno [13], 2019	1	0	Case report
Caudle [14], 2016	marked node evaluation: 191 TAD evaluation: 118	1.4% of TAD (4.2% of marked node biopsy only)	Of 208 patients with marked nodes, 191 underwent ANC and 118 underwent SNB and ANC The clipped node was not identified in the surgical specimen in 5 patients, who were excluded from analysis
Flores-Funes [15], 2019	22	0% of TAD (0% of marked node only)	23 patients had a marked node and all underwent ANC Marked node excision was successful in 22 cases
Siso [16], 2018	35	4.1%	The ILINA trial involved 35 patients who had a clipped node excised along with SLNs, followed by ANC
Park [17], 2018	10	0	Patients with cytology-proven node metastases underwent charcoal tattooing before NAC Detection rate of tattooed nodes was 100%
Sutton [18], 2020	marked node evaluation: 24 TAD evaluation: 29	7% of TAD (17% of marked node biopsy only)	29 patients with node-positive disease received NAC and TAD The clipped node was found in 25 patients Some, but not all, patients underwent ANC
Taback [19], 2018	19	0 of TAD (0 of marked node biopsy only)	19 patients with N+ disease underwent fiducial reflector insertion in the positive node Some, but not all, patients underwent ANC The marked node was identified in all 19 patients in the reflector group

N0, node-negative; N+, node-positive; TAD, targeted axillary dissection; SNB, sentinel-node biopsy; ALND, axillary lymph node dissection; ANC, axillary node dissection; NAC, neoadjuvant chemotherapy; US, ultrasound; MARI, marking the axilla with radioactive iodine seeds; TAS, targeted axillary sampling involving sentinel and marked nodes as well other nodes in the vicinity.

^aReflects the number of patients used to calculate the FNR, or the best possible approximation.

^bRadioactive nodes and/or nodes containing blue dye, tattooed nodes, and clinically suspicious nodes at inspection or palpation during surgery were removed. In some patients, extended TAS was performed, i.e., the excision of several nodes around the sampled nodes.